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Observational Study
. 2023 Jan 14:19:13-20.
doi: 10.2147/VHRM.S388754. eCollection 2023.

The Outcomes of PBMV in Pregnancy, and When is the Best Time?

Ahmed Hussein  1 , Mohamed Eid  1 , Sharaf E D Mahmoud  1 , Mohamed Sabry  2 , Ali Altaher  1
Affiliations
Observational Study

The Outcomes of PBMV in Pregnancy, and When is the Best Time?

Ahmed Hussein et al. Vasc Health Risk Manag. .

Abstract

Background: Percutaneous balloon mitral valvuloplasty (PBMV) is considered the most suitable option for managing symptomatic severe mitral valve stenosis (MS) during pregnancy with favorable anatomy. We do not know the best time to perform PBMV during pregnancy to achieve the best maternal and fetal outcomes. Therefore, we conducted this study to clarify the best procedure timing.

Methods: This prospective, observational, single-center study involved 44 pregnant patients suffering from symptomatic MS who underwent PBMV from May 2017 to May 2020. A detailed history is taken, full clinical examination, laboratory assessment, 2 D echocardiography, and follow-up during the hospital stay and monthly until labor.

Results: We found that the mean mitral valve area (MVA) had significantly increased from 1.12 ± 0.24 to 2.09 ± 0.46 cm2 (P < 0.001). The mean pressure gradient across the mitral valve reduced from 17.22 ± 5.55 to 8.94 ± 3.75 mmHg (P < 0.001). The procedures were successful in 91% of the patients. Regarding obstetric outcomes, the incidence of preterm labor, fetal death, and composite adverse outcomes was significantly lower in patients who had the procedure during the second trimester than those who had the procedure during the third trimester. All preterm deliveries and intrauterine fetal deaths occurred at least 21 days after PBMV. The patients showed a statistically significant improvement in NYHA functional classification.

Conclusion: We can conclude that PBMV performed in pregnant patients is an effective and safe treatment modality, and we observed better obstetric outcomes achieved with early intervention during the second trimester.

Keywords: PBMV; mitral stenosis; obstetric outcomes; pregnancy; rheumatic heart disease.

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Conflict of interest statement

The authors report no conflicts of interest for this work.

Figures

Figure 1
Figure 1
Post procedure adverse obstetric outcomes during the second and third trimesters.
See this image and copyright information in PMC

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