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Mild Pulmonary Valve Stenosis

Last post 04-25-2009 9:36 PM by momandmidwife. 3 replies.
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  • 04-24-2009 6:07 AM

    Mild Pulmonary Valve Stenosis

    Hello all,

    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

     

  • 04-25-2009 7:43 PM In reply to

    Re: Mild Pulmonary Valve Stenosis

     I believe you will find after reviewing her case notes that the best thing for her birth is the one with the least stress.  A quiet homebirth with no coached pushing and no restrictions on her body and soul will be best.  Surely a surgical birth with all the risks involved would be her worst choice.  She could help herself alot now by following a good healthy  diet and not gaining an excessive amount of wt.  The Brewer diet and meditation is her best option IMO.

    claudia

    Women and cats will do as they please and men and dogs should relax and get used to the idea. - Robert A Heinlein
  • 04-25-2009 8:11 PM In reply to

    • midwifea
    • Top 10 Contributor
    • Joined on 02-12-2009
    • Kailua Kona, HI
    • Posts 475

    Re: Mild Pulmonary Valve Stenosis

    I was just getting back on here to answer this but I find Claudia's reply to be very much as I would have said.

    I have had 3 primip women with mitral valve prolapse, birth at home with me.  All 3 did just fine, only 1 opted to take the recommended prophylactic antibiotics during 2nd stage.

    Gentle birthing for this mama and lots of love.

    Blessings,
    April
    moderator

    "The Voice

    There is a voice inside of you
    That whispers all day long,
    "I feel this is right for me,
    I know that this is wrong."
    No teacher, preacher, parent, friend
    Or wise man can decide
    What's right for you--just listen to
    The voice that speaks inside."
    — Shel Silverstein
  • 04-25-2009 9:36 PM In reply to

    Re: Mild Pulmonary Valve Stenosis

     Thanks, ladies, for the replies.  These were exactly my thoughts...what better place to decrease your stress levels, and thus cardiac output, than at home?  I hope to get the chance to meet with her.  She seems to have fallen off the map, though, as we hadn't firmed up a time next week.  She may be reconsidering, we'll see.  I know she was conversing with other MWs in the area, too, and as long as she finds a good fit for her...that's what it's all about :)

     

     

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