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Master's Dissertation
DOI
10.11606/D.5.2010.tde-27052010-164816
Document
Author
Full name
Alessandra Fernandez Fernandes
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2010
Supervisor
Committee
Zugaib, Marcelo (President)
Borges, Vera Therezinha Medeiros
Liao, Adolfo Wenjaw
Title in Portuguese
Valvopatia mitral em gestantes: repercusões maternas e perinatais
Keywords in Portuguese
Classe funcional
Complicações obstétricas
Descompensação cardiaca
Ecocardiograma
Estenose mitral
Gestantes
Gestantes cardiopatas
Insuficiência mitral
Medicamentos cardiovasculares
Pequeno para idade gestacional
Repercussões maternas
Repercussões perinatais
Valvopatia mitral
Abstract in Portuguese
Os objetivos deste estudo foram correlacionar o tipo de lesão valvar mitral com eventos maternos e neonatais. É um estudo retrospectivo, observacional, realizado na Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina de São Paulo. Foram coletados dados de 117 gestações em 111 mulheres com valvopatia mitral e 117 recém-nascidos resultantes destas gestações. No grupo estudado, foram observados 71 casos de gestantes portadoras de insuficiência mitral e 46 casos de gestantes portadoras de estenose mitral e seus 117 recém-natos. O tipo de lesão valvar, a estenose mitral, esteve significantemente relacionado piores classes funcionais (com predominância de CF III/IV), a maior necessidade de uso de medicamentos cardiovasculares, à maior freqüência de internação para compensação do quadro cardíaco, a maiores índices de parto cesárea, a menor média ponderal ao nascimento e a maior incidência de RNs pequenos para idade gestacional. Entretanto, a lesão valvar predominante não influiu com relevância estatística quanto à presença de complicações obstétricas, presença de co-morbidades clínicas, a complicações fetais, índice de Apgar < 7, e necessidade de UTI neonatal. A presença de valvopatia mitral na gravidez, principalmente a estenose mitral, acompanha-se de riscos maternos e perinatais
Title in English
Maternal and perinatal events in pregnant women with mitral valve disease
Keywords in English
Cardiovascular drugs
Ecocardiografhy
Funcional class
Heart failure symptoms
Maternal events
Mitral regurgitation
Mitral stenosis
Mitral valvular heart disease
Obstetrics complications
Perinatal events
Pregnant women
Pregnant women with heart disease
Smallfor gestational age babies
Abstract in English
PURPOSE: To evaluate the maternal (clinical e obstetrical) and perinatal events related to the predominant valvar lesion in pregnant women with mitral valve disease. This is a Observational and retrospective study of 117 pregnancies in 111 patients with mitral disease, followed in a single tertiary center from January 2004 until August 2008. Clinical and obstetrical data were reviewed and analyzed according to the main type of valvar lesion (stenosis or insufficiency). The statistical analysis of the results was performed by chi-square test, Fishers exact test, and Mann-Whitney test. Among the 117 pregnancies (and neonates), there were 71 cases of predominant mitral regurgitation (MR group) and 46 with predominant mitral stenosis. The MS group presented more severe heart failure symptoms (functional class III and IV) during pregnancy, received more cardiovascular drugs and needed more hospital admissions due to cardiac reasons . Concerning perinatal events, MS presented higher rates of cesarean sections, smaller birthweight and higher incidence of SGA (small for gestational age, babies. Nevertheless, the predominant valvar lesion was not significantly related to other clinical co-morbidities, obstetrical or perinatal complications. Mitral valve disease in pregnancy is related to clinical and perinatal events, especially in patients with predominant mitral stenosis
 
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Publishing Date
2010-05-28
 
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