[Pregnancy in XXXX with heart valve prosthesis. A French retrospective cooperative study (155 cases)].

@entity1 @entity154 @entity5852 @entity944 @entity4219 @entity1031 @entity715 @entity340 @entity204
A French cooperative study of 155 pregnancies in 103 @entity1 with @entity340 (95 mechanical, 60 bioprostheses including 27 bivalvular prostheses) is reported. Therefore, a total of 182 prostheses (108 mechanical and 74 bioprostheses) were exposed to the risk of pregnancy. The maternal outcome in the group of 108 mechanical prostheses was complicated by 16 @entity1031 ( @entity1031 ) including 10 prosthetic valve @entity715 which required emergency valve replacement in 4 cases, 6 systemic @entity1031 in 13 mitral, 2 aortic and 1 pulmonary mechanical prostheses. The @entity1031 were four times more frequent in @entity1 on heparin than in those on oral anticoagulants. There were 4 deaths, 3 among the 10 prosthetic valve @entity715 (one reoperation, two @entity944 ). Seven of the 74 bioprostheses were reoperated for degeneration on average 5.9 years after the initial operation but there were no deaths or @entity1031 . The outcome of pregnancy was 99 @entity1 (63%), 49 of which were born to mothers with mechanical prostheses (53%) and 50 to mothers with bioprostheses (80%) (p < 0.001). Seven of the @entity1 were born prematurely, all mothers being on anticoagulant therapy. The birth weight was over 400 grams heavier (3 kg versus 2.6 kg) in the bioprosthesis group (p < 0.05). The 20 spontaneous @entity5852 (13%) were more common in patients on anticoagulants (17%) than in those without (2%) (p < 0.02). @entity154 due to oral anticoagulants were rare (one certain case). There was one case of @entity4219 , an abnormality which has never been described in this context. The 36 remaining pregnancies were still deaths (N = 5), abortion due to maternal @entity204 (N = 4), maternal complications (N = 8), therapeutic (N = 9) or @entity5852 (N = 10) (28 mechanical and 8 bioprostheses).(ABSTRACT TRUNCATED AT 250 WORDS)
