Results
Maternal Outcome
Of 1,000 pregnant women, 765 (76.5%) had no cardiovascular
complications during the study; the remaining 235
(23.5%) patients experienced cardiovascular events, shown in
Table II in decreasing order of frequency.
In patients with rheumatic heart disease, there were 119
(21.4%) complications (Table III). Congestive heart failure
and pulmonary congestion occurred in 54 (63.5%) patients
with moderate or severe mitral stenosis (mitral valve area
below 1.5 cm2 assessed by Doppler echocardiogram), 19
(22.3%) with valve regurgitation, 12 (14.1%) with bioprostheses,
related in 10 patients to bioprosthesis dysfunction (7
detected before gestation). Among the 20 patients with cardiac
arrhythmias, 16 were in atrial fibrillation associated
with mitral valve disease. Eight episodes of thromboembolism
occurred in native mitral valves (five associated with
atrial fibrillation, with three of these following a regimen of
anticoagulation recommended in the protocol), and four in
mechanical prostheses. Infective endocarditis was observed
in one patient with aortic regurgitation during Week 19 of
ResultsMaternal OutcomeOf 1,000 pregnant women, 765 (76.5%) had no cardiovascularcomplications during the study; the remaining 235(23.5%) patients experienced cardiovascular events, shown inTable II in decreasing order of frequency.In patients with rheumatic heart disease, there were 119(21.4%) complications (Table III). Congestive heart failureand pulmonary congestion occurred in 54 (63.5%) patientswith moderate or severe mitral stenosis (mitral valve areabelow 1.5 cm2 assessed by Doppler echocardiogram), 19(22.3%) with valve regurgitation, 12 (14.1%) with bioprostheses,related in 10 patients to bioprosthesis dysfunction (7detected before gestation). Among the 20 patients with cardiacarrhythmias, 16 were in atrial fibrillation associatedwith mitral valve disease. Eight episodes of thromboembolismoccurred in native mitral valves (five associated withatrial fibrillation, with three of these following a regimen ofanticoagulation recommended in the protocol), and four inmechanical prostheses. Infective endocarditis was observedin one patient with aortic regurgitation during Week 19 of
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