Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, USA.
College of Medicine, University of Kentucky, Lexington, KY, USA.
Infect Dis (Lond). 2021 Aug;53(8):633-639. doi: 10.1080/23744235.2021.1912821. Epub 2021 Apr 27.
Endocarditis during pregnancy carries a maternal mortality of up to 30%, but prior publications do not reflect the current opioid epidemic.
We reviewed our institution's infective endocarditis registry from 2009 to 2019 and identified 19 females with endocarditis during pregnancy in order to compare our contemporary outcomes with historical reports. In our cohort, intravenous drug use was reported in all cases, and the most common pathogen was (74%) followed by (13%). The tricuspid valve was involved in 18 (95%) patients, and contrary to prior reports, all but two patients were managed conservatively with antibiotics alone. Maternal and infant mortality (5% and 0%, respectively) were lower in our cohort compared to all previous reviews.
We conclude that the better outcomes seen in this report are likely due to the younger age of the patients and the more frequent right-sided valvular involvement.
This review highlights contemporary outcomes in endocarditis during pregnancy. We review historical case reports in light of the opioid epidemic. We observed more , more right-sided valvular involvement, and more conservative management as well as improved maternal and foetal mortality.
怀孕期间的心内膜炎可导致高达 30%的孕产妇死亡率，但之前的出版物并未反映当前的阿片类药物流行情况。
我们回顾了我们机构 2009 年至 2019 年的感染性心内膜炎登记处，并确定了 19 名患有妊娠期间心内膜炎的女性，以便将我们的当代结果与历史报告进行比较。在我们的队列中，所有病例均报告有静脉药物使用，最常见的病原体是 （74%），其次是 （13%）。18 名（95%）患者的三尖瓣受累，与之前的报告相反，除了两名患者之外，所有患者均单独使用抗生素进行保守治疗。与所有先前的综述相比，我们队列中的孕产妇和婴儿死亡率（分别为 5%和 0%）较低。
我们得出的结论是，报告中观察到的更好的结果可能是由于患者年龄更轻，更常见的右侧瓣膜受累。
本综述强调了怀孕期间心内膜炎的当代结果。我们根据阿片类药物流行情况回顾了历史病例报告。我们观察到更多的 ，更多的右侧瓣膜受累，更保守的治疗以及改善的孕产妇和胎儿死亡率。
