Among the following valvular lesions encountered in pregnancy, which is generally BEST tolerated because the falling systemic vascular resistance reduces the regurgitant load?

• A Severe mitral stenosis
• B Severe pulmonary stenosis
• C Moderate aortic regurgitation with normal LV function ✓
• D Mitral stenosis with atrial fibrillation

Explanation

Regurgitant lesions are usually well tolerated in pregnancy because the physiological fall in systemic vascular resistance lessens backward flow, while the rise in heart rate and stroke volume helps maintain forward output. Stenotic lesions behave oppositely: fixed obstruction plus the tachycardia, expanded volume and high output state of pregnancy raises left atrial pressure and precipitates pulmonary oedema, which is why severe mitral stenosis, especially with atrial fibrillation, is among the highest risk lesions.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.