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 Altaher1 1Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Sohag University Egypt, Sohag, Egypt; 2Department of OB/GYN, Faculty of Medicine, Sohag University Egypt, Sohag, EgyptCorrespondence: Ahmed Hussein,...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-01-01
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| Series: | Vascular Health and Risk Management |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-outcomes-of-pbmv-in-pregnancy-and-when-is-the-best-time-peer-reviewed-fulltext-article-VHRM |
| _version_ | 1797952273339383808 |
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| author | Hussein A Eid M Mahmoud SED Sabry M Altaher A |
| author_facet | Hussein A Eid M Mahmoud SED Sabry M Altaher A |
| author_sort | Hussein A |
| collection | DOAJ |
| description | Ahmed Hussein,1 Mohamed Eid,1 Sharaf E D Mahmoud,1 Mohamed Sabry,2 Ali Altaher1 1Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Sohag University Egypt, Sohag, Egypt; 2Department of OB/GYN, Faculty of Medicine, Sohag University Egypt, Sohag, EgyptCorrespondence: Ahmed Hussein, Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Sohag University, Nasser City, Sohag, 82524, Egypt, Tel +2 01011145537, Fax +2 0934600349, Email ahmed_hussien@med.sohag.edu.egBackground: 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: rheumatic heart disease, mitral stenosis, PBMV, pregnancy, obstetric outcomes |
| first_indexed | 2024-04-10T22:43:41Z |
| format | Article |
| id | doaj.art-418251f1219543d291742f9590afbb70 |
| institution | Directory Open Access Journal |
| issn | 1178-2048 |
| language | English |
| last_indexed | 2024-04-10T22:43:41Z |
| publishDate | 2023-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Vascular Health and Risk Management |
| spelling | doaj.art-418251f1219543d291742f9590afbb702023-01-15T18:00:23ZengDove Medical PressVascular Health and Risk Management1178-20482023-01-01Volume 19132081007The Outcomes of PBMV in Pregnancy, and When is the Best Time?Hussein AEid MMahmoud SEDSabry MAltaher AAhmed Hussein,1 Mohamed Eid,1 Sharaf E D Mahmoud,1 Mohamed Sabry,2 Ali Altaher1 1Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Sohag University Egypt, Sohag, Egypt; 2Department of OB/GYN, Faculty of Medicine, Sohag University Egypt, Sohag, EgyptCorrespondence: Ahmed Hussein, Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Sohag University, Nasser City, Sohag, 82524, Egypt, Tel +2 01011145537, Fax +2 0934600349, Email ahmed_hussien@med.sohag.edu.egBackground: 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: rheumatic heart disease, mitral stenosis, PBMV, pregnancy, obstetric outcomeshttps://www.dovepress.com/the-outcomes-of-pbmv-in-pregnancy-and-when-is-the-best-time-peer-reviewed-fulltext-article-VHRMrheumatic heart diseasemitral stenosispbmvpregnancyobstetric outcomes. |
| spellingShingle | Hussein A Eid M Mahmoud SED Sabry M Altaher A The Outcomes of PBMV in Pregnancy, and When is the Best Time? Vascular Health and Risk Management rheumatic heart disease mitral stenosis pbmv pregnancy obstetric outcomes. |
| title | The Outcomes of PBMV in Pregnancy, and When is the Best Time? |
| title_full | The Outcomes of PBMV in Pregnancy, and When is the Best Time? |
| title_fullStr | The Outcomes of PBMV in Pregnancy, and When is the Best Time? |
| title_full_unstemmed | The Outcomes of PBMV in Pregnancy, and When is the Best Time? |
| title_short | The Outcomes of PBMV in Pregnancy, and When is the Best Time? |
| title_sort | outcomes of pbmv in pregnancy and when is the best time |
| topic | rheumatic heart disease mitral stenosis pbmv pregnancy obstetric outcomes. |
| url | https://www.dovepress.com/the-outcomes-of-pbmv-in-pregnancy-and-when-is-the-best-time-peer-reviewed-fulltext-article-VHRM |
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