Study of outcome of pregnancy in women with heart disease

Abstract

Background: Heart disease complicates 1% of all pregnancies. Objective of the study is to evaluate the maternal and fetal outcome in patients with cardiac disease in pregnancy.Methods: An observational study was carried out in 25 pregnant women with known or newly diagnosed heart disease at tertiary care hospital.Results: The average age of women was 21-25 (36%), in which primigravida 52% and 48% were multigravida. 56% patients were unbooked and 44% booked. Rheumatic heart disease was the commonest aetiology and was found in 56% of patients. While 16% patients had RHD with PAH. Three (12%) patient had prosthetic valve replacement. 8% patient had Congenital heart disease while 8% had peripartum cardiomyopathy. 60% delivered vaginally and 40% of them had delivered by LSCS for various obstetrical indications. In our study none of the patient required therapeutic termination of pregnancy. Majority of patients 92% in our study group had no obstetric maternal complications. Two (8%) maternal mortality occurred in our study. Low birth weight babies were 24%, preterm labour in 4% patient. 8% babies were growth restricted. Regarding fetal outcome 25 were live birth babies. None of the patient had congenitally malformed baby and there was no perinatal loss in this study.Conclusions: Early diagnosis of heart disease, regular antenatal checkups, institutional delivery and collaboration between cardiologist and obstetrician should result in a fall in maternal deaths from conditions already diagnosed before pregnancy.

Impact and outcome of cardiac diseases in pregnancy

“…In developing countries like India, incidence of rheumatic heart disease is still high as compared to developed countries where incidence of congenital disease is higher than RHD. 4,6 As shown in Table 6, pulmonary oedema 25%, peripartum cardiomyopathy 10.7% and congestive heart failure 10.7% were common complications seen in present study which corresponds to the study by Shah et al which had similar rates of 23.5% and 8.8% and 14.7% respectively. 7 Non-cardiac complications like PIH, wound gap, APH and anaemia were seen in 18%, 3.6%, 3.6% and 7.2% of patients respectively in present study which is comparable to study by Joshi et al 4 Maternal mortality was 7.2%.…”