The Spectrum of Heart Disease in Pregnancy and its Outcome in Patients Visiting a Tertiary Care Centre of Northeastern: A Prospective Study

Khan, Dina Aisha; Sharma, Neeraj; Kapoor, Manish; Duwarah, Sourabh Gohain; Ahanthem, Santa Singh

doi:10.7860/jcdr/2018/35407.11837

Cited by 8 publications

(11 citation statements)

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“…9,10 The mean age of women with heart disease in our study was 24±4 years, consistent with similar studies. 8,9 Notably, the majority of cardiac cases in our study were attributed to rheumatic heart disease (RHD) at 59% and congenital heart disease (CHD) at 13%, aligning with the findings of Dina Aisha Khan et al, who reported a 41.83% prevalence of RHD. The higher incidence of RHD in developing countries is attributed to factors such as low socioeconomic status, poverty, poor nutrition, inadequate sanitation, and limited access to healthcare services.…”

Section: Discussionsupporting

confidence: 91%

“…1,2 In our study, the prevalence of heart disease in pregnancy was 2.07%, aligning closely with findings by Dina Aisha Khan et al, where the prevalence was 2.32%. 8 Comparable prevalence rates, ranging from 1.3 to 4.3%, were observed in studies conducted both in India and internationally. 9,10 The mean age of women with heart disease in our study was 24±4 years, consistent with similar studies.…”

Section: Discussionmentioning

confidence: 93%

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Unveiling the spectrum of cardiac disease complicating pregnancy: A comprehensive exploration of maternal and fetal outcomes

Mathesan,

Kirubamani

2024

IJOGR

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Cardiac diseases pose a significant non-obstetrical threat to maternal well-being during pregnancy, contributing to nearly 10% of maternal mortality. The intersection of pregnancy and cardiac disease presents a complex scenario, affecting approximately 1-3% of pregnancies. Rheumatic heart disease (RHD) remains a prevalent issue in developing countries, while advancements in pediatric cardiology have increased survival rates for congenital heart disease. This exploration aims to comprehensively understand the impact of cardiac diseases on maternal and fetal outcomes during pregnancy.A prospective observational study conducted over 1 year and 6 months included 40 pregnant women with cardiovascular disease. Antenatal investigations, electrocardiogram, and echocardiography were performed. Maternal and fetal outcomes were assessed, and data were presented as descriptive statistics. The study revealed a 2.07% prevalence of cardiac disease in 1926 deliveries, with a mean age of 24±4 years. Cesarean section was the predominant mode of delivery (70%). Most cases had NYHA grade I disease (80%). Maternal outcomes were uneventful in 88%, and only 12% had ICU admission. Complications due to cardiac disease were observed in 17.5% of participants. Neonatal outcomes included NICU admission (25%), low birth weight (22.5%), and preterm birth (20%).Cardiovascular complications in pregnancy affect up to 4% of cases. The prevalence in this study aligns with existing literature. Rheumatic heart disease and congenital heart disease were predominant, consistent with global trends. Maternal and perinatal outcomes were favorable in NYHA grades I and II, emphasizing the importance of early intervention and healthcare accessibility.Cardiac disease is a substantial risk factor for maternal mortality during pregnancy. The study highlights the dual risk of balancing maternal well-being and fetal development. Prevalence, complications, and outcomes underscore the significance of pre-pregnancy counseling, early detection, and multidisciplinary management for optimal pregnancy outcomes.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 93%

Unveiling the spectrum of cardiac disease complicating pregnancy: A comprehensive exploration of maternal and fetal outcomes

Mathesan,

Kirubamani

2024

IJOGR

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“…Peripartum cardiomyopathy (40.9%) was the leading cause of cardiac morbidity in our study, and it was the only cause of cardiac-related maternal mortality. That was unlike in most parts of India, where rheumatic heart disease and congenital heart diseases were the leading cause of morbidity and mortality [ 27 - 28 ]. It may be because most of the valvular heart diseases were diagnosed early in the pregnancy and hence optimized adequately before delivery, whereas cardiomyopathies are usually diagnosed late.…”

Section: Discussionmentioning

confidence: 99%

Maternal Near-Miss as a Surrogate Indicator of the Quality of Obstetric Care: A Study in a Tertiary Care Hospital in Eastern India

Singh¹,

Barik²

2021

Cureus

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Background Monitoring severe acute maternal morbidity or maternal near-miss is currently proposed by WHO as a valuable tool to assess the quality of obstetric care and implement new strategies for improving maternal health. Aim and objective The objective of this study was to assess and analyze the incidence of maternal near-miss (MNM) and maternal death (MD) at Tata Main Hospital, Jamshedpur, a tertiary care hospital in eastern India. Material and method This study was a prospective observational study conducted at Tata Main Hospital from November 2016 to October 2019. The study population included all the pregnant women who fulfilled the WHO near-miss criteria based on organ dysfunction or failure and all the maternal deaths that occurred during the study period. Results During the study period, there were 15,377 deliveries and 14,636 live births. The MNM cases were 153, and 38 were maternal deaths. The maternal near-miss ratio (MNMR) and severe maternal outcome ratio (SMOR) were 19.9 and 13.1 per 1000 live births, respectively. The maternal near-miss to mortality ratio (MNM: 1 MD) was 4:1, and the mortality index (MI) was 19.9%. Haemorrhagic disorders were the leading cause (40.5%) of MNM, followed by hypertensive disorders (25.5%) and cardiac diseases (14.4%). Similarly, both haemorrhage (23.7%) and sepsis (23.7%) were the leading causes of death followed by hypertensive disorders (15.8%). On reviewing patients, 62% of near-miss and 92% of mortality cases had shown organ dysfunction on admission. Conclusion MNM and MD cases share similar pathology with a different outcome. Hence, monitoring a larger volume of MNM cases helps in identifying the causes of maternal adverse events and finding out the gaps in the management more effectively than auditing only the maternal deaths.

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“…Rheumatic heart disease (RHD) is the most common cardiac disease in India unlike in developed countries where congenital heart disease (CHD) is more common. CHD is on the rise due to improving medical facilities, awareness among patients, early diagnosis and management [2]. Pregnancy increases the risk of common vascular events and also the rarer events like aortic dissection (AD)/aortic rupture [3] and this is even more pronounced in patients with predisposing aortopathies like heritable vascular disease, hereditary fibrillinopathies, and cono-truncal defects [4].…”

Section: Introductionmentioning

confidence: 99%

Aortic complications in pregnancy: the less remembered chapter—a narrative review

Rajasekaran¹,

Praveena²,

Idhrees³

et al. 2021

Exploration of Medicine

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Pregnancy increases the risk of common vascular events and also the rarer events like aortic dissection (AD)/aortic rupture and this is even more pronounced in patients with predisposing aortopathies. AD was found to occur in 0.0004% of all pregnancies, and it is more pronounced in patients with underlying connective tissue disorders. The normal hemodynamic changes on a weak aorta will lead to AD and/or rupture, more so with increase in the period of gestation. Hence the haemodynamic and hormonal changes during pregnancy make pregnancy itself a risk factor for AD. It is advised that women with Marfan syndrome who are planning pregnancy should go through prophylactic aortic repair if the diameter of the ascending aorta exceeds 4 cm. Pre-pregnancy counselling is very important in these patients and must include complete history taking, including family history, physical examination and advanced aortic imaging. There is a general consensus among various authors advising against surgery during pregnancy in stable patients due to increased maternal and fetal morbidity but it is justified if the condition is refractory to medical management or in life threatening stage like acute AD. Though the incidence of aortopathy in pregnancy is rare, there is a high maternal and fetal mortality associated with this condition.

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The Spectrum of Heart Disease in Pregnancy and its Outcome in Patients Visiting a Tertiary Care Centre of Northeastern: A Prospective Study

Cited by 8 publications

References 0 publications

Unveiling the spectrum of cardiac disease complicating pregnancy: A comprehensive exploration of maternal and fetal outcomes

Unveiling the spectrum of cardiac disease complicating pregnancy: A comprehensive exploration of maternal and fetal outcomes

Maternal Near-Miss as a Surrogate Indicator of the Quality of Obstetric Care: A Study in a Tertiary Care Hospital in Eastern India

Aortic complications in pregnancy: the less remembered chapter—a narrative review

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