<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Objective</h3><p>Maternal heart disease is one of the major causes for mortality among parturients. In our study, we surveyed 220 patients with different valvular disorders who gave birth in our medical center in the years 2012–2018. The aim of this study was to characterize various valvular pathologies and compare the results of different anesthetic approaches.</p></sec><sec><h3>Methods</h3><p>In this retrospective study, the computerized system and file archive were searched for maternal valvular pathologies according to the International Classification of Diseases, Ninth Revision (ICD-9). The women included in the study were defined as American Society of Anesthesiology (ASA)-II or more, who suffer from valvular heart disease.</p></sec><sec><h3>Results</h3><p>The most common pathology was mitral valve regurgitation (57.73% of all cardiac patients). Most women were defined as having mild insufficiency, and 82.68% had normal vaginal delivery. In 17.3% of patients who had cesarean section, the main type of anesthesia was neuraxial anesthesia (95.45%). The second most common pathology was tricuspid valve regurgitation (22.73%). Most patients (78%) had normal vaginal delivery, and epidural analgesia was used in 64.1%. A minority of cardiac patients in our study were patients with stenotic heart diseases, such as aortic stenosis, mitral stenosis and pulmonic stenosis (8.18%, 4.55%, and 1.36%, respectively). No complications were observed in the peripartum period.</p></sec><sec><h3>Conclusion</h3><p>The use of regional anesthesia is recommended for all valvular pathologies without exception, as we observed no cases in which the severity of cardiac condition had not allowed the use of various types of regional anesthesia, for surgery or vaginal delivery.</p></sec></abstract>

ObjectiveMaternal heart disease is one of the major causes for mortality among parturients. In our study, we surveyed 220 patients with different valvular disorders who gave birth in our medical center in the years 2012–2018. The aim of this study was to characterize various valvular pathologies and compare the results of different anesthetic approaches.MethodsIn this retrospective study, the computerized system and file archive were searched for maternal valvular pathologies according to the International Classification of Diseases, Ninth Revision (ICD-9). The women included in the study were defined as American Society of Anesthesiology (ASA)-II or more, who suffer from valvular heart disease.ResultsThe most common pathology was mitral valve regurgitation (57.73% of all cardiac patients). Most women were defined as having mild insufficiency, and 82.68% had normal vaginal delivery. In 17.3% of patients who had cesarean section, the main type of anesthesia was neuraxial anesthesia (95.45%). The second most common pathology was tricuspid valve regurgitation (22.73%). Most patients (78%) had normal vaginal delivery, and epidural analgesia was used in 64.1%. A minority of cardiac patients in our study were patients with stenotic heart diseases, such as aortic stenosis, mitral stenosis and pulmonic stenosis (8.18%, 4.55%, and 1.36%, respectively). No complications were observed in the peripartum period.ConclusionThe use of regional anesthesia is recommended for all valvular pathologies without exception, as we observed no cases in which the severity of cardiac condition had not allowed the use of various types of regional anesthesia, for surgery or vaginal delivery.

Outcome of Peripartum Anesthesia in Women with Valvular Disease

Department of Anesthesiology, Perioperative Medicine and Pain Treatment

Shaare Zedek Medical Center, affiliated with Hebrew University

Romanian Journal of Anaesthesia and Intensive Care

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"Outcome of Peripartum Anesthesia in Women with Valvular Disease"}

ObjectiveMaternal heart disease is one of the major causes for mortality among parturients. In our study, we surveyed 220 patients with different valvular...

Mitral incompetence
Total		127
Age (years)		27–41
ASA	ASA-II	ASA-III	Total
ASA	121 (95.28%)	6 (4.72%)	127 (100%)
Vaginal delivery	With epidural anesthesia	Without epidural anesthesia	Total
Vaginal delivery	75 (71.43%)	30 (22.57%)	105 (100%)
Cesarean section	Regional anesthesia	General anesthesia	Total
Cesarean section	21 (95.45%)	1 (4.55%)	22 (100%)

Pathology	Number out of 220	% from 220	% from the general population	% of ASA-II	% of NVD	% of C/S	% NVD + NA	% C/S + GA	% of C/S and NA
Mitral insufficiency	127	57.73	0.127	95.28	82.68	17.32	71.43	4.55	95.45
Mitral stenosis	10	4.55	0.01	90	70	30	71.43	0	100
Aortic insufficiency	9	4.09	0.008	66.67	67	33	50	0	100
Aortic stenosis	18	8.18	0.018	83.33	50	50	66.67	0	100
Tricuspid insufficiency	50	22.73	0.05	88.00	78	22	64.10	9	91
Tricuspid stenosis	0	0	0	0	0	0	0	0	0
Pulmonary insufficiency	3	1.36	0.004	100	66.67	33.33	50	0.00	100
Pulmonary stenosis	3	1.36	0.004	100	100	0	66.67	0	0

Aortic stenosis
Total		18
Age (years)		20–41
ASA	ASA-II	ASA-III	Total
ASA	15 (83.33%)	3 (16.67%)	18 (100%)
Vaginal delivery	With epidural anesthesia	Without epidural anesthesia	Total
Vaginal delivery	6 (66.67%)	3 (33.33%)	9 (100%)
Cesarean section	Regional anesthesia	General anesthesia	Total
Cesarean section	9 (100%)	0 (0%)	9 (100%)

Outcome of Peripartum Anesthesia in Women with Valvular Disease

Article Category: Research Article

Data publikacji: 10 sie 2020

Zakres stron: 11 - 14

DOI: https://doi.org/10.2478/rjaic-2020-0001

Słowa kluczowe
anesthesia, obstetric, pregnancy, valvular heart disease

© 2020 Daniel Shatalin et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Characteristics of patients with Mitral incompetence

Summary of data analysis

Characteristics of patients with Aortic stenosis

Outcome of Peripartum Anesthesia in Women with Valvular Disease

Article Category: Research Article

Data publikacji: 10 sie 2020

Zakres stron: 11 - 14

DOI: https://doi.org/10.2478/rjaic-2020-0001

Słowa kluczoweanesthesia, obstetric, pregnancy, valvular heart disease

© 2020 Daniel Shatalin et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Characteristics of patients with Mitral incompetence

Summary of data analysis

Characteristics of patients with Aortic stenosis

Słowa kluczowe
anesthesia, obstetric, pregnancy, valvular heart disease