Heart valve disease constitutes the majority of all causes of heart disease during pregnancy. Women with heart valve disease are vulnerable to deterioration with subsequent increased risk of maternal and fetal morbidity and mortality.
The optimal treatment is indecisive; on one hand medical treatment might relieve symptoms but causes hypoxia and have adverse effects on the developing fetus, while interventional therapy might increase the risk of maternal and fetal complications. No randomised controlled trials addressing the optimal treatment have been performed. Therefore, there is insufficient evidence to define the optimal treatment of heart valve disease during pregnancy.
Additional. Observational studies are the only available information on this subject. This implies a selection bias; case series with reasonable outcome might be reported more frequent than those with poor outcome. Although observational studies might imply a selection bias, these studies are the best available evidence in adverse maternal and neonatal effects and are described in detail.