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Pregnancy in women with valvular heart disease
  1. Karen K Stout,
  2. Catherine M Otto
  1. Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
  1. Correspondence to:
    Dr K K Stout
    Division of Cardiology, Box 356422, University of Washington, 1959 Pacific NE, Rm AA522, Seattle, WA 98195, USA; stoutk{at}


Patients with valvular disease who desire pregnancy or are already pregnant require specialised care. Ideally, women undergo preconceptual counselling that addresses any procedures needed to decrease the risks of pregnancy, including valve replacement, if the patient has symptoms at baseline. Management during pregnancy includes replacing any contraindicated medications with safer alternatives, optimising loading conditions, careful monitoring and aggressive treatment of any exacerbating factors. Rarely, percutaneous or surgical intervention is required during pregnancy. Labour and delivery often require invasive haemodynamic monitoring and a multi-disciplinary team for optimal maternal and fetal outcomes.

  • UFH, unfractionated

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  • Published Online First 11 August 2006

  • Competing interests: None.

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    BMJ Publishing Group Ltd and British Cardiovascular Society
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    BMJ Publishing Group Ltd and British Cardiovascular Society