Leaky Heart Valves Increase Pregnancy complications

A form of heart valve disease during pregnancy may put women at risk for serious bleeding, high blood pressure, organ damage, and other complications during childbirth, according to research from Johns Hopkins Medicine.

A new study published in the American Journal of Cardiology suggested this finding based on an analysis of more than 20,000 individual medical records.

‘Pregnant women with a history of leaky heart valves are 100 times more likely to experience cardiac complications at the time of delivery.’

Although relatively rare among pregnant women in the United States, heart valve disease causes complications such as premature labor and heart failure in up to 10% of women giving birth each year.

Heart's four valves such as mitral, tricuspid, pulmonic and aortic keep the blood flowing in the correct direction. Most risk-assessment guidelines focus on any degree of stenosis, or narrowing and tightening of valves that reduces blood flow and causes extra strain on the heart.

This new study is inspired by experiences with women who had a history of severe valvular disease and the relative lack of up-to-date research about the value of current assessment tools.

The research team used data from the 2016-2018 National Inpatient Sample, a large government-funded dataset of hospital admissions, to compare demographics, medical conditions, and obstetric and cardiovascular complications during the time of delivery.

From a total of about 11.2 million delivery hospitalizations across 48 states and the District of Columbia, 20,349 women had a documented history of valvular heart disease.

Researchers reported that most women with valvular disease were older and had a higher prevalence of underlying medical conditions such as high blood pressure and diabetes compared with women without valvular disease.

Among obstetric and fetal complications, preeclampsia, a potentially dangerous pregnancy complication caused by high blood pressure, and placental abruption, when the placenta detaches from the womb causing poor oxygen flow to the baby were more common in women with valvular heart disease.

They also found that the risk of hemorrhage during delivery was 40% more likely among those with any form of heart valve disease.

These findings highlight the need for revising risk calculators for pregnant women to include a history of leaky heart valves and pregnant women with any form of cardiovascular disease should receive specialized care from a cardio-obstetric team.

Source: Medindia