Mitral Valve Prolapse: How Will a Heart Murmur Affect My Pregnancy?

I am five weeks pregnant, and was told at my first exam that I would have to have antibiotics during delivery because I have a heart murmur (mitral valve prolapse). I was told very little else about possible risks of a heart murmur and pregnancy. I have hardly noticed my murmur over the years, but over the last week and a half, every time I lie down to go to sleep, I have heart palpitations for up to 10 minutes.


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Heart murmurs are very common in pregnancy, due to changes brought on by hormones and by the increase in blood volume. Most pregnant women have a systolic end murmur. Yours, however, because it is due to mitral valve prolapse, needs more consideration than the typical murmur of pregnancy.

Mitral valve prolapse is the most common congenital heart condition found in women of childbearing age. According to Gabbe's "Obstetrics: Normal and Problem Pregnancies," the incidence appears to be about 12 percent. There appears to be a genetic predisposition to this condition. Most women with MVP have no symptoms, while some experience palpitations. According to Gabbe, "Most women with MVP have uneventful pregnancies."

The need for antibiotics is still debated. The American Heart Association has advised that antibiotics are not necessary in most patients undergoing routine vaginal or cesarean delivery. Others suggest treating only those patients who have mitral "regurgitation." But because it is difficult to differentiate those with a severe form of this condition from those with only a mild defect, most physicians do order prophylactic antibiotics.

If a client becomes symptomatic during pregnancy, it may be a good idea to order an echocardiogram and ultrasound. I usually refer all of my patients with MVP to the obstetrician, who sometimes refers them to a cardiologist for recommendations for the pregnancy.

If you have no shortness of breath or pain or faintness, I would guess that these palpitations are a response to increasing blood volume, but I would order a cardiologist referral to be safe.

I wish you the best with your pregnancy and thanks for writing.


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