DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20204003

Fetomaternal outcomes in pregnancy with different cardiac disease at a tertiary care center in Udaipur

Keerti Chaudhary, Sangeeta Sen

Abstract


Background: The incidence of maternal cardiac diseases has an adverse effect on pregnancy outcomes. The present study was done the objective to determine the Incidence and distribution of cardiac disease in pregnant patients, to assess mode of delivery and fetomaternal outcome in pregnancy with heart disease patients.

Methods: This was a hospital based prospective observational study that include 65 pregnant women with diagnosed cardiac disease or had symptoms and signs suggestive of cardiac disease during the period from January 2018 to December 2019. Baseline data recorded including age, parity, gestational age, cardiac lesions, New York heart association (NYHA) functional class, use of cardiac medications, thorough clinical examination including chest and cardiovascular auscultation, ECG and echocardiographic assessment of left and right ventricular systolic function. Fetomaternal outcome was analysed in the study.

Results: The mean age of the patients was 24.33±2.93 years (ranging from 19-36 years). 34 patients (52.30%) were primigravida. Majority (58.46%) cases were from rural area. Majority patients (70.77%) are present between 37-40 weeks of gestational age. Most of patients had vaginal delivery (64.62%). 43 patients (66.15%) diagnosed with heart disease after pregnancy, while 22 patients (33.85%) are diagnosed before pregnancy for heart disease. Neonatal complications were seen in in 35.38% of patients. Cardiac complications were present in 40% of patients. majority of fetal complications are in nonoperated patients (46.15%).

Conclusion: The management of pregnant women with cardiac diseases requires multidisciplinary approach to prevent morbidity and mortality. It is necessary to optimize healthcare facilities to obtain maximum maternal and fetal outcome.

 


Keywords


Fetomaternal outcome. Pregnancy, Cardiac diseases

Full Text:

PDF

References


N.K.A.W, Mook V, Peters L. Severe cardiac disease in pregnancy, part 2: impact of congenital and acquired disease during pregnancy. Lippincott Williams and Wilkins. 2005;11:435–48.

Salam S, Mushtaq S, Mohi-udDin, Gul I, Ali A. Maternal and fetal outcome in pregnancy with heart disease in tertiary care hospital in India. Int J Reprod Contracept Obstet Gynecol. 2017;6:3947-51.

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.

Ahmed N, Kausar H, Ali L, Rakhshinda. Fetomaternal outcome of pregnancy with Mitral stenosis. Pak J Med Sci. 2015;31(3):643-7.

Prasanna Kosuru ML, Aruna Kumari K. Clinical study of maternal and perinatal outcome in heart disease complicating pregnancy at tertiary referral center of Telangana State. Int J Gynaecol. 2018;8(2):46-54.

Sayeeda S, Fatima Wahid S, Begum F, Zaman MM. A Two Years Study on Pregnant Women with Cardiac Disease in a Tertiary Care Centre. Bangladesh J Obstet Gynaecol. 200823(1):8-14.

Treviño ER, Delgado GT, Navarro A. Perinatal outcomes in pregnant women with heart disease: Hospital General León experience. Int J Reprod Contracept Obstet Gynecol. 2019;8(1):54-8.

Khan DA, Sharma N, Kapoor M, Duwarah SG, Ahanthem SS. The Spectrum of Heart Disease in Pregnancy and its Outcome in Patients Visiting a Tertiary Care Centre of Northeastern: A Prospective Study. J Clinical Diagnostic Res. 2018;12(7):16-20.

Pandey K, Verma K, Gupta S, Jahan U, Kirti, Gupta P. study of pregnancy outcome in women with cardiac disease: a retrospective analysis. Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3537-41.

Agrawal S, Agrawal A, Bhandari M, Siddiqui SS, Koonwar S. Critical analysis of all pregnancies with heart disease, misses and near misses over 1-year period along with expert group so as to optimize outcome and improve patient care – Need-based analysis. Heart India. 2019;7(2):55-62.

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(2):120-3.

Konar H, Chaudhuri S. Pregnancy Complicated by Maternal Heart Disease: A Review of 281 Women. J Obstet Gynaecol India. 2012;62(3):301-6.

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.

Bhatla N, Lal S, Behera G, Kriplani A, Mittal S, Agarwal N, Talwar KK. Cardiac disease in pregnancy. Int J Gynaecol Obstet. 2003;82(2):153-9.