A 28-year-old woman with known severe aortic stenosis (valve area 0.6 cm²) is found to be 6 weeks pregnant. She is in NYHA Class I. What is the most appropriate management?
- A Continue pregnancy with close monitoring and beta-blockers
- B Recommend termination followed by aortic valve replacement ✓
- C Perform balloon valvuloplasty in the second trimester
- D Start diuretics and continue pregnancy
Correct answer: B. Recommend termination followed by aortic valve replacement
Explanation
Severe aortic stenosis (valve area <1.0 cm²) carries a maternal mortality of up to 17% during pregnancy due to inability to augment cardiac output. Preconception valve correction is ideal. If diagnosed early in pregnancy, termination before 12 weeks followed by valve replacement is recommended. Balloon valvuloplasty is a temporizing measure with significant fetal risk and is reserved for cases where termination is refused.
Reference: Williams Obstetrics, 25th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.