Clinical study of maternal and perinatal outcome in heart disease complicating pregnancy at tertiary referral center of Telangana State
Journal Title: Medpulse International Journal of Gynaecology - Year 2018, Vol 8, Issue 2
Abstract
Background: Heart disease remains a leading cause of indirect maternal deaths during pregnancy accounting for 20% of all cases. Many significant circulatory changes accompany pregnancy in women with preexisting cardiovascular disease, these alterations in haemodynamics can be dangerous. Therefore, patients should be evaluated for underlying cardiac disease to select appropriate management. Aims: The aim of this study is to evaluate the influence of biological factors in Maternal and Perinatal Outcome in Heart Disease Complicating Pregnancy. Materials and Methods: This study was conducted in Modern Government Maternity Hospital, Petlaburj, Osmania Medical College, Hyderabad from December 2014 to December 2016.Prospective and descriptive study. Sample size is 75. Results: Incidence of heart disease complicating pregnancy is 0.5%. RHD constituted for 64% of cases, CHD for 32% of cases. The ratio of 330+2 RHD: CHD was 2:1. Incidence of peripartum cardiomyopathy was 2.6% and that of cardiac arrhythmias was 1.3%. In patients with RHD, MS was seen in 40% of cases either alone or in combination with other valvular lesions. Severe MS was seen in 6 cases whereas mild MS was seen in 4 cases. In CHD group, most common lesion was ASD (41%).NYHA class I/II was seen in 70% and III/IV was seen in 30% of patients at the time of registration. Hypothyroidism was the commonest associated medical disorder. IUGR was most common obstetric risk factor. A total of 8% of patients developed cardiac complications, 5.3% of patients had CHF and 2.6% had pulmonary edema. Two patients developed CHF in third trimester. 32% of babies required NICU admission for prematurity (12%) and growth restriction (20%). Live birth rate was higher in cases with NYHA class I/II than in those with NYHA class III/IV (98% Vs 90.9%). IUGR (15% Vs 31%), Preterm birth (9.4% Vs 18%), were higher in patients with functional class III/IV than in those with class I/ II. Maternal mortality rate was 2%. Conclusion: Preconceptional counselling, accurate risk assessment, regular antenatal checkups, prevention, early recognition and aggressive treatment of complications during pregnancy are crucial in reducing the morbidity. Surgical correction of the cardiac lesion prior to pregnancy is associated with better pregnancy outcome.
Authors and Affiliations
Lakshmi Prasanna Kosuru, K Aruna Kumari
Keywords
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- EP ID EP470462
- DOI 10.26611/101283
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