. Author manuscript; available in PMC: 2021 Jan 1.

Published in final edited form as: Am J Obstet Gynecol. 2019 Jul 13;222(1):77.e1–77.e11. doi: 10.1016/j.ajog.2019.07.019

Table 3:

Details of patients with assisted second stage for cardiac disease.

Case	Disease	Details of Cardiac Disease^a	Minutes of Valsalva	Outcome
1	Marfan Syndrome	Aortic root 3.3 cm with strong family history of dissection	75	Uncomplicated vacuum-assisted delivery
2	Marfan Syndrome	Aortic root 3.3 cm with strong family history of dissection	30	Uncomplicated forceps-assisted delivery
3	Aortic Stenosis	Subaortic stenosis s/p repair and resultant moderate stenosis and severe regurgitation	15	Uncomplicated vacuum-assisted delivery
4	Aortic Stenosis	Severe aortic stenosis s/p aortic valve replacement with development of ascending aortic aneurysm (peak gradient 79 mmHg mean gradient 47 mmHg)	75	Uncomplicated vacuum-assisted vaginal delivery; postpartum aortic valve replacement
5	Aortic Stenosis	Severe but stable aortic stenosis (peak gradient 79 mmHg mean gradient 47 mmHg)	0	Forceps-assisted vaginal delivery complicated by fourth degree perineal laceration and breakdown requiring multiple reoperations

Aortic root area and peak and mean aortic valve gradient listed for patients on the transthoracic echocardiogram closest to delivery.