AI Article Synopsis
- The study looked at how infective endocarditis (IE) affects pregnant women who don’t use drugs and included cases from 14 hospitals over many years.
- Most women in the study were around 33 years old and had their babies about 30 weeks along; many had no prior heart issues.
- Most women faced serious problems, like heart failure and complications with their pregnancies, including some that resulted in surgery or even loss of the baby; one woman sadly died from the illness.
Article Abstract
Objectives: To describe the clinical features and outcomes of infective endocarditis (IE) in pregnant women who do not inject drugs.
Methods: A multinational retrospective study was performed at 14 hospitals. All definite IE episodes between January 2000 and April 2021 were included. The main outcomes were maternal mortality and pregnancy-related complications.
Results: Twenty-five episodes of IE were included. Median age at IE diagnosis was 33.2 years (IQR 28.3-36.6) and median gestational age was 30 weeks (IQR 16-32). Thirteen (52%) patients had no previously known heart disease. Sixteen (64%) were native IE, 7 (28%) prosthetic and 2 (8%) cardiac implantable electronic device IE. The most common aetiologies were streptococci (n = 10, 40%), staphylococci (n = 5, 20%), HACEK group (n = 3, 12%) and Enterococcus faecalis (n = 3, 12%). Twenty (80%) patients presented at least one IE complication; the most common were heart failure (n = 13, 52%) and symptomatic embolism other than stroke (n = 4, 16%). Twenty-one (84%) patients had surgery indication and surgery was performed when indicated in 19 (90%). There was one maternal death and 16 (64%) patients presented pregnancy-related complications (11 patients ≥1 complication): 3 pregnancy losses, 9 urgent Caesarean sections, 2 emergency Caesarean sections, 1 fetal death, and 11 preterm births. Two patients presented a relapse during a median follow-up of 3.1 years (IQR 0.6-7.4).
Conclusions: Strict medical surveillance of pregnant women with IE is required and must involve a multidisciplinary team including obstetricians and neonatologists. Furthermore, the potential risk of IE during pregnancy should never be underestimated in women with previously known underlying heart disease.
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| http://dx.doi.org/10.1093/jac/dkac258 | DOI Listing |
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