Evaluation of maternal and fetal outcomes in pregnancy with heart disease

Jayshree Mulik, Rahul Patil


Background: Heart diseases complicate >1% of all pregnancies and is the leading indirect cause of maternal deaths. Present study attempted determining the maternal and fetal outcome in pregnant women with heart disease using various relevant parameters.

Methods: A total of 44 consecutive cases of heart disease with pregnancy that were admitted at the study centre from December 2013 to August 2015 were included and analyzed for outcome with respect to age, parity, associated comorbidities, nature of cardiac lesions, type of valvular involvement, NYHA functional class, type of anaesthesia used, mode of delivery, maternal outcome, fetal outcome, birth weight of babies and maternal and fetal mortality, if any.

Results: Rheumatic heart disease 26 (59.1%) was the commonest lesion observed to be affecting pregnant patients, followed by congenital heart disease (10, 22.7%). Mitral valve (30, 68.2%) was found most commonly affected, followed by aortic valve (10, 22.7%). Regurgitant lesions (26, 59.09%) were commoner than stenotic ones (14, 31.81%). Four (9.1%) patients went into left ventricular failure and had to be admitted to ICU. Of these, one patient (2.3%) died.

Conclusions: Maternal heart disease is one of the important causes of maternal mortality. The obstetrician needs to have strong suspicion of the entity right from the start, so as to improve upon the maternal as well as fetal outcomes.


Heart disease, Obstetric outcome, Pregnancy

Full Text:



Trinidad D, Cox RA. Heart diseases during pregnancy. P R Health Sci J. 2006:25(3):259-65.

Simpson LL. Maternal cardiac disease: update for the clinician. Obstet Gynecol. 2012;119(2 Pt 1):345-59.

Berg CJ, Callaghan WM, Syverson C, Henderson Z. Pregnancy-Related Mortality in the United States, 1998 to 2005. Obstet Gynecol. 2010;116(6):1302-09.

Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL et al. William Obstetrics ,24th Edition, Aplleton and Lange 2014;973.

Bitsch M, Johansen C, Wennvold A, Osler M. Maternal heart disease, a survey of a decade in a Danish University Hospital. Acta Obstet Gynecol Scand. 1989;68(2):119-24.

Fernando Arias. Practical guide to high risk pregnancy and delivery, 2nd ed;P:48-52.

Asghar F, Kokab H. Evaluation and outcome of pregnancies complicated by heart disease. J Pak Med Assoc. 2005;55(10):1-2.

Vidyadhar B, Singh R, Shinde K. Clinical study of heart disease complicating pregnancy. IOSR J Pharm 2012;2(4):25-28.

Guleria R, Vashist K, Dhall G, Grover A, Wahi P. Pregnancy with heart disease: Experience at PGIMER, Chandigarh. J Physicians India 1990;38(12):902-6.

Pratibha D, Kiranmai D, Rani VU, Vani NG. Pregnancy outcome in chronic rheumatic heart disease. J Obstet Gynecol India. 2009;59(1):41-46.

Walkiria S, Eduardo G, Jose Antonio F, Maxgrinberg, Maria R, Marcelo Z et al. Pregnancy in patients with heart disease: Experience with 1000 cases. Clin Cardiology 2003;26(3):135-42.

Deshmukh MA, Desai S, Motashaw ND. Heart disease in pregnancy. J Obstet Gynecol India 1979;29:996-99.

Sawhney H, Aggarwal N, Suri V. Maternal and perinatal outcome in rheumatic heart disease. Int J Gynaecol Obstet. 2003;80(1):9-14.