Terumo glidewire: The wire of choice for chronic total occlusion

✍ Scribed by Zimarino, Marco ;Rasetti, Gerardo ;Venarucci, Vincenzo ;Pagliacci, Marcello

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 265 KB
• Volume: 34
• Category: Article
• ISSN: 0098-6569
• DOI: 10.1002/ccd.1810340424

✦ Synopsis

Letters to the Editor

Caution in Use of Beta Blockers During Pregnancy

TO THE EDITOR I read with interest the article on percutaneous balloon mitral valvuloplasty during pregnancy by Kalra et al. [l] and the accompanying editorial comment by Block [2]. I agree with the latter that intensive medical therapy may avoid any interventional procedures for many women who become symptomatic with mitral stenosis during pregnancy. However, I would like to caution against the use during pregnancy of beta blockers as rate-controlling agents, especially "for patients in sinus rhythm." I assume Dr. Block meant patients not in sinus rhythm.

Even then beta blockers, both cardioselective and noncardioselective, have important maternal and fetal side effects. For example, they can increase the uterine tone and contractility and decrease umbilical blood flow [3]. Therefore, beta blockers should be used cautiously in the lowest possible dose, especially during the last phase of pregnancy, and should be discontinued before labor because of their effects on the uterus and to prevent neonatal complications [3]. Furthermore, propranolol also has a possible teratogenic effect [ 31.