Background: Congenital anomalies make an important contribution to infant mortality and they remain a leading cause of death in many countries of the world. Many babies also died in our country due to congenital anomalies. Methods: This retrospective cross-sectional study was conducted at the Departments of Obstetrics and Gynecology of CMCH between October 2016 to March 2017. Objective of the study was to find out the risk factors of non-cardiac congenital anomaly of fetus. The study population of those women who delivered a baby with different non-cardiac congenital anomalies admitted in Departments of Obstetrics and Gynecology of CMCH. Results: The mean maternal age was found 26.6±5.6 years and the mean paternal age was found 35.8±7.9 years. 28 (28.0%) patients had hydrocephalus, 25 (25.0%) had Anencephaly, 7 (7.0%) had Omphalocele, 7 (7.0%) had Hydrops fetalis, 6 (6.0%) had cleft lip, 6 (6.0%) had cleft palate, 4 (4.0%) had cleft lip and cleft palate. 20 (20.0%) patients had consanguinity, history of high-grade fever with rash in first trimester was 12 (12.0%). 16(16.0%) was diabetes mellitus. Majority (63.0%) patients belonged to gestational age 16-28 weeks. The mean gestational age was found 29.5±7.1 weeks with ranged from 16 to 42 weeks. Majority (89.0%) were singleton pregnancy. 60% reveal congenital anomaly in USG. Conclusion: Risk factors of non-cardiac congenital anomalies were consanguinity, maternal obesity, high grade fever with rash in first trimester due to viral infection, diabetes mellitus (uncontrolled), uncontrolled gestational diabetes mellitus, previous birth defect, inadequate intake of folic acid in first trimester, blood group Rh negative, male baby. Hydrocephalus and anencephaly were the most common congenital anomalies. Cardiovasc. j. 2020; 13(1): 40-45
Coronary artery disease in pregnancy is a catastrophic situation that may endanger the lives of both the mother and the fetus. Cardiac diseases may account for up to 15% of maternal mortality. Pregnancy may increase the risk of acute myocardial infarction up to 4-fold. Various hemodynamic derangements may occur during pregnancy including expansion of plasma and blood volume, compression of inferior vena cava and fall in both systemic and pulmonary vascular resistances. If pregnant women present with acute coronary artery disease, medical management should be attempted first and if any intervention or surgery is needed, efforts must be made to lower the risk. A multidisciplinary approach is essential involving obstetrician, cardiologist, cardiac surgeons, anesthesiologist and neonatologists or pediatrician. Pregnancy is considered to be a relative contraindication to thrombolytic therapy due to some complications. Revascularization may be considered in acute coronary syndrome in pregnant women like other nonpregnant patients. Primary per cutaneous coronary intervention or coronary artery bypass graft have been performed successfully during pregnancy and may be considered as therapeutic option in pregnancy in selective cases. Percutaneous coronary intervention (PCI) is considered to be relatively safe for maternal and fetal survival during pregnancy. Main worry in PCI is radiation exposure and need to dual antiplatelet therapy. Bare metal stent is preferred during pregnancy because of shorter duration of anticoagulation therapy. Early second trimester is the optimum surgical period to coronary artery bypass surgery (CABG) in pregnant women. Coronary artery bypass surgery can be safely done after 28 weeks of gestational age and immediately after cesarean section. Early detection, a multidisciplinary approach and timely interventions must be considered in coronary artery disease in pregnancy for better obstetric outcome. Cardiovasc j 2021; 14(1): 61-69
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