Clinical features and management of right-sided infective endocarditis during pregnancy: analysis of seven cases
10.3760/cma.j.cn113903-20201203-01196
- VernacularTitle:妊娠合并右心感染性心内膜炎的临床特征与治疗：七例分析
- Author:
Yong CHEN
1
;
Shuang LIU
;
Guangfa ZHU
;
Yanna LI
;
Jian CAO
;
Ruiyu DOU
Author Information
1. 首都医科大学附属北京安贞医院呼吸与危重症医学科 100029
- Keywords:
Pregnancy complications;
Endocarditis;
Pregnancy outcome
- From:
Chinese Journal of Perinatal Medicine
2021;24(8):584-590
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To describe the characteristics and management of right-sided infective endocarditis (RSIE) during pregnancy.Methods:The clinical manifestation, blood culture, echocardiography, diagnosis, treatment, and maternal and infant outcomes of seven patients with RSIE during pregnancy from Capital Medical University Affiliated Beijing Anzhen Hospital from January 2009 to March 2020 were retrospectively collected and described.Results:The incidence of RSIE during pregnancy was 0.27‰ (7/25 832). All patients had a history of congenital heart disease, with a mean age of (26.0±2.7) years and a mean gestational age at onset of (28.7±6.6) weeks. Cardiac murmur, fever, dyspnea, cough, expectoration, and pulmonary rales were the common symptoms. Seven cases were complicated by anemia, seven with hypoproteinemia, six with hypoxemia, five with pulmonary hypertension, and five with positive blood culture. Echocardiography indicated that vegetations were mainly attached to the pulmonary valves (four cases), followed by the tricuspid valves (three cases) and the right ventricular outflow tract (three cases). Four patients were diagnosed with septic pulmonary embolism by chest X-ray. All patients were treated with intravenous antibiotics. Cesarean section was performed on five cases in the third trimester and one in the second trimester due to intrauterine death. The other case underwent vaginal delivery in the third trimester. Cardiac surgery was conducted during the hospitalization in four cases and not in the other three. The mean length of stay was 26 days (12-76 days). Six cases were cured, and one died after discharge. Among the six neonates, one had asphyxia and was died after withdrawal of treatment. The remaining five infants survived and developed well during the follow-up of 5 years (3-10 years).Conclusions:Pregnancy complicated by RSIE is a rare and critical condition, requiring early diagnosis to make optimal treatment strategies, reducing maternal and infant fatality.
