FETOMATERNAL OUTCOME IN PREGNANCY WITH CARDIAC DISEASE

Abstract

Objective(S): Cardiac disease is an important cause of maternal morbidity and mortality in both antepartum as well as in postpartum period. Incidence of heart disease with pregnancy is <1%. Aim of this study is to determine maternal complications with heart disease, mode of delivery & fetal complications.

Materials & Methodology: This is a retrospective study conducted at Gopinath Maternity Home, Sir-T Hospital, Bhavnagar. From May 2020- April 2021. All pregnant women with various cardiac disease (previously established or diagnosed during pregnancy) who came to labor room or OPD are included.

Result: 30 pregnant women out of 2683 deliveries were identified with cardiac disease giving prevalence of 1.12% in this study. 15(50%) women belonging to NYHA class-1 & 8(26.6%) belonged to NYHA class 2. Class 3(3 patients =10%) & class 4(4patients= 13.3%) were admitted immediately. 18(60%) women were case of valvular heart disease, out of which 12(66.6%) cases were of RHD, 2(11.1%) were MS, 3(16.6%) AS, 1(5.5%) MR. 10(33.33%) cases were congenital heart disease. Maternal mortality were 4(13.33%). Out of 30 cases, 18(69.2%) women had LSCS, 6(23.07%) had vaginal delivery,2(7.7%) had vaccum & 3(10.3%) had abortion. Out of 26 deliveries 2(7.7%) were IUFD, 6(23.07%) Preterm, 7(26.9%) IUGR. Total there were 9(37.5%) NICU admissions.

Conclusion: Prognosis of pregnancy with heart disease has improved but management of it is still a challenge for obstetricians. Pre-conceptional counseling plays an important role by benefiting women with severe heart disease and thus help in reducing maternal morbidity and mortality.

Keywords:  cardiac disease, maternal outcome, fetal outcome