Maternal-fetal monitoring during dental procedure in patients with heart valve disease

Summary Background: The effects of local dental anesthesia with lidocaine and epinephrine on cardiovascular parameters of pregnant women with heart valve diseases and their fetuses are not fully understood. Objectives: To assess and analyze cardiotocographic, blood pressure and electrocardiographic parameters of pregnant women with rheumatic heart valve disease undergoing local anesthesia with 1.8mL of lidocaine 2% with or without epinephrine 1:100,000 during restorative dental treatment.Methods: Maternal ambulatory blood pressure and electrocardiographic monitoring as well as cardiotocography of 31 patients with rheumatic heart disease were performed between the 28th and 37th week of gestation. The patients were divided into two groups, those with or without vasoconstrictor. Results: A significant reduction in maternal heart rate was shown in both groups during the procedure in comparison with the other periods (p 0.05). The same occurred (p>0.05) with the number of uterine contractions, baseline level and variability, and number of accelerations of fetal heart rate.Conclusion: The use of 1.8mL of lidocaine 2% in combination with epinephrine was safe and efficient in restorative dental procedures during pregnancy in women with rheumatic heart valve disease. (Arq Bras Cardiol 2009; 93(5) : 430-438)Key Words: Electrocardiography, ambulatory / methods; blood pressure monitoring, ambulatory / methods; cardiotocography / methods; anesthesia, local / methods; pregnant women; rheumatic heart disease.