Aortic Stenosis

Rheumatic aortic stenosis in pregnancy is usually nssociatecl with rheumatic ~nitral stenosis and occurs approximately in five per cent oC pregnant women with rheumatic  valvular disease. Most patients with aortic stenosis with valve area or >1.5 cm2 tolerate pregnancy well. Those who have more severe lesions may deteriorate clinically with exertional dyspnoea neas'syncope or syncope with pulmonary edema. Such patients with severe symptoms, resistant to medical therapy may need Lerminntion of pregnancy or Lhese patients may undergo surgical repair or replacement of aortic valve or may undergo percutaneous balloon valvuloplasty.

Congenital Aortic Stenosis

Congential aortic stenosis seen in young women is usually a congential bicuspid valve with stenosis. Mild to moderate aortic stenosis eith preserved left ventsicular function, is usually well tolerated duiing pregnancy. However, severe aortic stenosis with valve asea of < l.OcmZ (with a gradient of >60mrn Hg) increases the risk in pregnancy. Symptoms like dyspnea, angina or syncope appear in second or third trimester of pregnancy. Ideally these women should undergo correction prior to pregnanacy. If diagoned during pregnancy, percutaneous ballon valveleplasty may be done piior to labor and delivery. Antibiotic prophylaxis is recommend duiing labour and delivery.