Study of heart disease in pregnancy and its effect on maternal outcome

Nitin Kumar Jain, Shabana Sultan


Background: Heart diseases in pregnant women and has higher incidence of maternal mortality and morbidity and is regarded as risk factor for unfavourable outcome of pregnancy both for the mother and the foetus. Heart disease in pregnancy was found to be second indirect cause contributing to maternal mortality in India.

Methods: This study is a hospital based prospective analytical study carried out in the Department of Obstetrics and Gynaecology, Sultania Zanana Hospital, Gandhi Medical College, Bhopal over a period of 1 year from 1st March 2017 to 28th February 2018. Patients were evaluated clinically by both obstetrician and cardiologist and followed all through their hospital stay till discharge.

Results: Total 51 cases of heart disease were found during the study period. Incidence of heart disease in our study during study period was found 0.25%. Most patients were unbooked 33(64.71%) and maximum number of patients belonged to NYHA functional class II 24 (47.06%), RHD cases were 4 times more common than CHD. 24 (47.06%) patients had undergone surgical intervention for heart disease. Congestive cardiac failure was most common complication seen. Three maternal deaths were seen. All cases belonged to NYHA functional class III. All 3 cases were unbooked presented first time in labor.

Conclusions: We found that pregnancy outcome was good in booked cases with regular checkup by obstetrician and cardiologist, surgically corrected cases and those with NYHA functional class I and II. Hence, joint management by obstetrician, cardiologist, and anesthetist is required to ensure better maternal outcome.


Congenital heart disease, Heart disease, Maternal outcome, Maternal mortality, Pregnancy, Rheumatic heart disease

Full Text:



Surge D, Blake S, McDonald D. Pregnancy complicated by maternal heart disease at the National Maternity Hospital, Dublin. 1969-1978.

McFaul P, Dornan J, Lamki H. Pregnancy complicated by maternal heart disease. A review of 519 women. Br J Obstet Gynaecol. 1998;95:861-7.

Bansode BR. Pregnancy and heart disease. Assoc Physicians Ind. 2010;773-6.

Siu SC, Sermer M, Colman JM. Prospective multicenter study of pregnancy outcome in women with heart disease. Circulation. 2001;104:515-21.

Konar H, Chaudhuri S. Pregnancy complicated by maternal heart disease: a review of 281 women. J Obstet Gynaecol India. 2012;62(3):301-6.

Pushpalatha K. Cardiac diseases in pregnancy- A review. JIMSA. 2010;23(4):269-74.

Kulkarni S, Huligol A. Maternal mortality -10 years study. J Obstet Gynecol Ind. 2001;51(2):155-8.

Whittemore R, Hobbins JC, Engle MA Pregnancy and its outcome in women with and without surgical treatment of congenital heart disease. Am J Cardiol. 1982;50(3):641-51.

Siu SC, Sermer M, Harrison DA, Grigoriadis E, Liu G, Sorensen S, et al. Risk and predictors for pregnancy-related complications in women with heart disease. Circulation. 1997;96(9):2789-94.

Sawhney H, Aggarwal N, Suri V, Vasishta K, Sharma Y, Grover A. Maternal and perinatal outcome in rheumatic heart disease. Int J Gynaecol Obstet. 2003;9-14.

Shime J, Mocarski E, Hastings D. Congenital heart disease in pregnancy: short- and long-term implications. Am J Obstet Gynecol. 1987;156:313-22.

Pujitha KS, Sheela SR, Jyothi NS. A study of maternal and fetal outcome in cardiac disease in pregnancy at tertiary care center. Int J Reprod Contracept Obstet Gynecol. 2017;6:5095-8.

Indira I, Jyothi SK. Study of pregnancy outcome in maternal heart disease. IOSR J Dental Med Sci (IOSR-JDMS). 2015;14(7):e-ISSN:2279-0853.

Nagamani G, Bhavani K, Vani Isukapalli, Lagudu S. Heart disease in pregnancy prospective study from southern India. Int J Current Med and Applied Sci. 2015;6(1):8-12.

Priya HL, Bhandiwad A, Desai N, Kondareddy T. Maternal outcomes of rheumatic heart disease in pregnancy. Int J Reprod Contracept Obstet Gynecol. 2017;6:802-6.

Arunachalam HG, Kodey PD, Gangadhara, Rao K, Satish RJ, Mounica E. Prospective study on heart disease complicating pregnancy. Int J Current Microbiol Applied Sci. 2015;4(8):215-22.

Selvarani G, Sivakumar GS, Swaminathan N, Ravishankar G, Paul GJ, Ramesh R, et al. Prevalence study on heart diseases among antenatal mothers. Int J Sci Stud. 2017;5(5):204-8.

Nqayana T, Moodley J, Naidoo DP. Cardiac disease in pregnancy. Cardiovas J Africa. 2008;19(3):145-51.

Joshi G, Joshi SC, Jha SK, Singh Y, Joshi A. Maternal heart disease and pregnancy outcome: Findings from a retrospective cohort in a tertiary care government hospital in Haldwani, Nainital. Nig J Cardiol. 2015;12:120-3.