Mitral stenosis and pregnancy / by Herbert French and H.T. Hicks.

  • French, Herbert Stanley, 1875-1951.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Mitral stenosis and pregnancy / by Herbert French and H.T. Hicks. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    We have, therefore, analysed the obstetric histories of 300 consecutive cases of mitral stenosis in women over twenty, who have been in Guy’s Hospital. We realise that it is extremely difficult to be certain of the date at which a grown-up Avoman Avith valvular heart disease first acquired it. In many cases of mitral stenosis there is no history of acute rheumatism or chorea. The mitral stenosis may be proved by autopsy to be old. It is believed that such cases have had endocarditis in childhood, Avhen the joint pains have been so slight that they have escaped the attention of the parents.^ Even when there has been an attack of rheumatic fever in early youth there is often no means of determining Avith certainty that the valvular disease has dated from it. In our analysis Ave have excluded all cases Avhere granular kidney Avas possible, and also those cases where the patient stated that rheumatic fever first occurred after tAventy years of age. We have taken those in which the clinical diagnosis has been old-standing mitral stenosis, Avith or Avithout other lesions, and in which there has been either rheumatic fever or chorea in childhood or youth, or no history of acute rheumatism at all. We have accepted the same evidence in all the cases, Avhether in married Avomen not pregnant, in married Avomen pregnant, or in single Avomen over tAventy, so that the analyses of each class are comparable. Our cases are given in tables at the end of the paper. Many Mitral Stenosis Cases bear Children well. The likelihood is, that any Avoman avIio has mitral stenosis Avill, sooner or later, suffer from the results of failing compensation. There are all degrees of mitral ^ Taylor, in ‘The Practice of Medicine,’ 1904, p. 157, says : “ . . . the cardiac lesions may occiu’ without any obvious affection of the joints at all. This greater liability on the part of the heart is especially frequent in children. . . .”