Which group of valvular lesions is generally BEST tolerated during pregnancy?
- A Pulmonary stenosis with right ventricular dysfunction
- B Left sided stenotic lesions such as aortic and mitral stenosis
- C Left sided regurgitant lesions such as aortic and mitral regurgitation ✓
- D Prosthetic valves requiring anticoagulation
Correct answer: C. Left sided regurgitant lesions such as aortic and mitral regurgitation
Explanation
The physiological fall in systemic vascular resistance reduces afterload and therefore decreases regurgitant volume, so chronic aortic and mitral regurgitation with preserved ventricular function is usually well tolerated. Stenotic lesions behave oppositely: fixed obstruction combined with the 40 to 50 percent rise in cardiac output forces a rise in transvalvular gradient and left atrial pressure, precipitating pulmonary oedema. Prosthetic valves add anticoagulation risks rather than pure haemodynamic burden, and pulmonary stenosis with RV dysfunction carries independent risk.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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