Published: 2021-01-28

Maternal and perinatal outcome in cardiac disease complicating pregnancy

Krupa R. Mange, Vidyadhar B. Bangal


Background: Maternal cardiac disease associated with pregnancy is considered as a high-risk pregnancy. Various physiological and hemodynamic alterations during the course of pregnancy make these women prone for various complications and related morbidity and mortality.

Methods: A prospective cross-sectional study of 105 cases of pregnancy complicated by cardiac disease, reporting to tertiary care hospital for delivery, was carried out to find out the maternal and perinatal outcome.

Results: The incidence of cardiac disease in pregnancy in the present study was 0.54%. Most of the women (91%) belonged to low socioeconomic class. Rheumatic heart lesions constituted 87% of the cases. Mitral stenosis alone or in combination, was the commonest (57%) valvular lesion. Incidence of spontaneous vaginal delivery was 53 percent and for ventose or outlet forceps was 12 percent. Incidence of caesarean section was 35%. There were 2 maternal deaths, one each due to complication like pulmonary oedema and atrial fibrillation. The perinatal mortality was 36 per 1000 live births, mainly due to combination of factors like prematurity, low birth weight, neonatal sepsis and birth asphyxia.

Conclusions: Early diagnosis of heart disease, regular antenatal checkup, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease.


Cardiac disease in pregnancy, Rheumatic heart disease, Maternal mortality

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Arafeh JM, Baird SM. Cardiac disease in pregnancy. Crit Care Nurs Q. 2006;29:32-52.

Dobbenga-Rhodes YA, Prive AM. Assessment and evaluation of the woman with cardiac disease during pregnancy. J Perinat Neonatal Nurs. 2006;20:295-30.

Stangl V, Baumann G, Stangl K. Pregnancy risks in acquired heart diseases. Z Kardiol. 2001;90:16-29.

Avila WS, Rossi EG, Ramires JA. Pregnancy in patients with heart disease: experience with 1000 cases. Clin Cardiol. 2003;26:135-14.

Siu SC, Sermer M, Harrison DA, Nunes Md, Rezende CA. Risk and predictors for pregnancy-related complications in women with heart disease. Circulation. 1997;96:2789-94.

Siu SC, Sermer M, Colman JM, Nunes Md, Rezende CA. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation. 2001;104:515-52.

Siu SC, Colman JM, Sorensen S. Adverse neonatal and cardiac outcomes are more common in pregnant women with cardiac disease. Circulation. 2002;105:2179-84.

Abdel-Hady ES, El-Shamy M, El-Rifai AA, Abdel-Samad A, Moussa S. Maternal and perinatal outcome of pregnancies complicated by cardiac disease. Int J Gynaecol Obstet. 2005;90:21-5.

Khairy P, Ouyang DW, Fernandes SM, Lee-Parritz A, Economy KE. Pregnancy outcomes in women with congenital heart disease. Circulation. 2006;113:517-24.

Clark SL. Cardiac disease in pregnancy. Crit Care Clin. 1991;7:777-97.

Barbosa PJ, Lopes AA, Feitosa GS, Almeida RV, Almeida RV, Brito JC et al. Prognostic factors of rheumatic mitral stenosis during pregnancy and puerperium. Arq Bras Cardiol. 2000;75:215-24.

Sawhney H, Aggarwal N, Suri V, Vasishta K, Sharma Y, Grover A et al. Maternal and perinatal outcome in rheumatic heart disease. Int J Gynaecol Obstet. 2003;80:9-14.