Cardiac complications of deliverance and modality of delivery in mitral stenosis about 83 cases

Background Mitral stenosis (MS) rheumatic continues to be the most common organic valve disease in poor countries. Available information regarding outcome of pregnancy in women with (MS) is limited to either small series. Purpose The aim of this study was to evaluate cardiac complications in patients with mitral stenosis. Methods This is a prospective descriptive study of 83 pregnant women from 2009 to 2012 at CHU Oran with echocardiographic and clinical monitoring until delivery and post-partum. Results We had 3 groups of patients according to severity (MS): group 1: mitral anatomy area (MVA) ≤ 1 cm 2 (20 parturients), 2nd group: 1 cm 2 2 (27 parturients), 3rd group: 1.6 cm 2  ≤ (MVA) ≤ 2 cm 2 (36 parturients), 80 patients have completed the pregnancy term with two abortions in group 2 and 1 in group 3. In the (group 1 and group 2): 10 presented cardiac complications during the delivery; with 05 acute pulmonary edema ( P  = 0.009) and 05 rhythm disturbances ( P  = 0.005). No cardiac complication of delivery in group 3. Caesarean delivery was performed in 64% (51) of cases there was a significant link between cesarean delivery and the severity of the RM with a ( P  = 0.01). Cardiological indication due to pulmonary hypertension complicated with cardiac heart failure was put in (25.50%) with 13/51 patients ( P  = 0.01). Conclusion These results call for a management strategy to prevent maternal and fetal complications, surgical repair of mitral stenosis operative stage, which prevents some gravido-cardiac complications For delivery, vaginal delivery is favored, cesarean section in this case being be reserved for purely obstetric indications is carried out in case of cardiac decompensation. The efficient management involves a multidisciplinary collaboration involving a cardiologist, an obstetrician, an anesthetist and a pediatrician.