Title: Effect of Pulmonary Stenosis on Pregnancy Outcomes Case-Control Study
Topic: Congenital Heart Disease
Date Posted: 12/17/2007
Study Question: What are the maternal and fetal outcomes of women with valvular pulmonary stenosis (PS)?
Methods: The authors performed a single-center case-control study of 17 women with PS. Patients were assessed for New York Heart Association (NYHA) functional class, maternal complications, and severity of PS. The study and control groups were compared for differences in birth weight, gestational age at delivery, Apgar scores, and placental weight. Comparisons were also made between patients with severe PS (gradient ≥50 mm Hg) and mild PS (gradient <50 mm Hg).
Results: Of 17 patients studied, 10 had mild PS and 7 had severe PS. At the time of presentation, 11 patients had NYHA class I, and 6 had NYHA class II symptoms. No patients with mild PS had clinical deterioration. One patient with severe PS progressed from NYHA class I to class II, and one transiently progressed from class II to class III. There were no statistically significant differences between patients and controls or between patients with mild and severe PS.
Conclusions: PS does not adversely impact maternal or fetal outcomes of pregnancy.
Perspective: PS is generally well-tolerated and nonprogressive. This study suggests a benign course for pregnant women with PS, as opposed to mitral and aortic stenosis, which have previously been shown to be associated with increased maternal risk. This study, with a relatively small sample size, shows safety of pregnancy in patients with various degrees of PS. Two patients with PS gradients >50 mm Hg showed progression of their symptoms, whereas none with mild stenosis progressed. It is possible that this trend could gain significance in a larger sample size.  Timothy B. Cotts, M.D.
肺动脉瓣狭窄对于孕妇的影响病例研究结果
话题：先天性心脏病
发表日期：2007.12.17
课题研究：肺动脉瓣狭窄孕妇的母性和胎儿的研究结果是什么？
方法：作者完成了一个独立的病例研究，研究对象是17名PS女性患者。这些病人都被纽约心脏病学院分化了功能等级，母性的并发症和PS的严重性。研究小组都对婴儿出生时的体重，阿普伽新生儿评分，胎盘的重量做了比较。在患有严重性PS患者之间也做了比较(gradient ≥50 mm Hg) and mild PS (gradient <50 mm Hg)
结果：研究的17名患者，10名患有中等程度的PS，7名患有严重性PS。在这篇文章发表的时候，11名患者已有了NYHA class I，6名患者有了NYHA class II症状。中等程度PS患者没有临床的变化。1位 严重性PS患者已从NYHA class I发展到了class II,1位患者暂时性的从class II发展到了class III。据统计，在病人和患有中等程度及严重的PS患者没有什么意义上的不同。
结论：PS没有对孕妇本身或胎儿产生逆反的作用。
观点：Timothy B. Cotts, M.D.认为，PS大体上可以被接受，没有什么新的发展。这份报告建议患有PS的孕妇患者在怀孕初期，反对治疗主动脉狭窄，据先前的研究表明这样做可能会增加母性的风险。这份以小群体所研究的报告还表明患有严重PS有孕妇患者的安全性，然而中等程度的血栓患者的病情没有什么变化。也许这种发展趋势对于在较大群体中研究可能会有一定的意义。

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