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Endocarditis in Pregnancy
Endocarditis usually occurs on previously damaged heart valves or is associated with shunt lesions or baffles. When seen on previously normal valves, endocarditis is most often on the right-sided valves and is associated with intravenous (IV) drug abuse. This chapter discusses the incidence and risk factors, diagnosis, and treatment of endocarditis in pregnancy.
Incidence and Risk Factors
Although endocarditis is rare in pregnancy (incidence of 0.03–0.14 per 1000 live births), it may be fatal. Pregnant women are at higher risk of endocarditis than their nonpregnant counterparts because pregnancy is an immunocompromised state, and certain infections, particularly urinary tract infections, are more common during pregnancy. Streptococcal infections are the most common cause of endocarditis.
The reported incidence of bacteremia with vaginal delivery is 0% to 5%. With cesarean section, it has been reported as high as 14%.
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