I am a frequent lurker, but now have a question. I have been contacted by a primip with a self-described mild congenital pulmonary valve stenosis who is seeking a homebirth. She has seen her cardiologist recently, and she reports that all cardiac function is normal, but he recommends that she be followed by a high-risk OB, "because why on earth would you want to give birth outside of a hospital???" I happen to know this cardiologist almost certainly wouldn't be supportive of ANY woman giving birth without all the bells and whistles of the hospital setting, so I'm not sure his opinion is completely unbiased.
She is coming in for a consult with me next week, and I've requested all of her cardiac records, so my back-up practice and I can review to see if she is indeed at increased risk for complications during birth. In my own research, it appears that a "mild" stenosis is not a problem, but "moderate to severe" should have antibiotics in labor for endocarditis prevention, and should be co-managed by perinatologists and cardiologists.
Has anyone cared for a woman at home with a mild pulmonary valve stenosis? Any stories, or great links for additional information? Thanks in advance...
Mom and midwife