Yuan Shi-Min, Yan Song-Li
The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Fujian Province, China.
Braz J Cardiovasc Surg. 2016 Apr;31(2):158-62. doi: 10.5935/1678-9741.20160034.
Mitral valve prolapse is a benign condition. Mitral regurgitation is only complicated in patients with severe mitral valve prolapse. Women with mitral valve prolapse in the absence of other cardiovascular disorders tolerate pregnancy well and do not develop remarkable cardiac complications. Nevertheless, serious complications of mitral valve prolapse, including arrhythmia, infective endocarditis and cerebral ischemic events, can be present in pregnancy. Debates remain with regard to the use of prophylactic antibiotics and β-blockers in the pregnant women with mitral valve prolapse. The prognosis of the pregnant patients might be closely related to the pathological and (or) functional changes of the mitral valve. Non-myxomatous mitral valve prolapse poses no or little obstetric risks in terms of pregnancy, labor and neonatal complications; whereas myxomatous mitral valve prolapse is a major etiology of valvular heart disease in women of childbearing age. In the pregnant patients with mitral valve prolapse progressing into major complications, surgical interventions are considered. Medicinal treatment of such patients with β-blockers should be a concern for the fetal safety.
二尖瓣脱垂是一种良性病症。二尖瓣反流仅在重度二尖瓣脱垂患者中较为复杂。无其他心血管疾病的二尖瓣脱垂女性耐受妊娠情况良好，且不会出现显著的心脏并发症。然而，二尖瓣脱垂的严重并发症，包括心律失常、感染性心内膜炎和脑缺血事件，在妊娠期间可能会出现。对于二尖瓣脱垂孕妇预防性使用抗生素和β受体阻滞剂仍存在争议。妊娠患者的预后可能与二尖瓣的病理和（或）功能改变密切相关。非黏液瘤性二尖瓣脱垂在妊娠、分娩及新生儿并发症方面无或几乎没有产科风险；而黏液瘤性二尖瓣脱垂是育龄期女性瓣膜性心脏病的主要病因。对于进展为严重并发症的二尖瓣脱垂妊娠患者，应考虑手术干预。此类患者使用β受体阻滞剂进行药物治疗时应关注胎儿安全。
