DOI: 10.36347/sjams.2014.v02i06.133

Pages: 3513-3519

Background: Mitral valve disease during pregnancy presents significant challenges in management and can lead to adverse maternal and fetal outcomes. This study analyzes the clinical characteristics, management strategies, and outcomes of pregnant women with mitral valve disease at Ibrahim Cardiac Hospital and Research Institute. Methods: This observational study included 60 pregnant women with mitral valve disease managed at our institution during July 2013 to June 2014. Comprehensive clinical and echocardiographic assessments were performed throughout pregnancy. Patients were managed according to standardized protocols with regular monitoring of maternal cardiac status and fetal wellbeing. Primary outcome measures included maternal cardiac complications, obstetric outcomes, and fetal/neonatal outcomes. Results: The mean age was 27.3 ± 4.8 years, with rheumatic heart disease being the predominant etiology (85%). At presentation, 45% were in NYHA class I, 35% in class II, and 20% in class III/IV. Cardiac complications occurred in 23.3% of patients, with heart failure (13.3%) being the most common. Vaginal delivery was achieved in 58.3% of cases. Adverse fetal outcomes occurred in 26.7% of pregnancies, including preterm delivery (20%) and low birth weight (23.3%). Medical management was successful in 88.2% of cases. Multivariate analysis identified NYHA class III/IV (OR 3.8, 95% CI 1.8-7.9), mitral valve area <1.5 cm² (OR 2.9, 95% CI 1.4-6.2), and pulmonary hypertension (OR 2.6, 95% CI 1.2-5.5) as independent predictors of adverse outcomes. Conclusion: With careful monitoring and appropriate management strategies, favorable outcomes can be achieved in pregnant women with mitral valve disease. Early risk stratification using identified predictive factors can guide management decisions. These findings provide valuable insights for managing such cases in resource-limited settings.