A 3 Year Study of Cardiac Disease in Pregnant Women in a Tertiary Care Set Up

Abstract

AIM AND OBJECTIVE:To analyze pregnant women with heart disease and to assess its influence on feto-maternal outcome. MATERIALS AND METHODS: The study was carried out during the period of November 2011 to October 2014. 45 pregnant women with cardiac diseases who were admitted in department of obstetrics and gynecology at KIMS hospital were included in the study. RESULTS: Rheumatic heart disease (n-24, 53.33 %) with isolated mitral stenosis (24.4%) was the predominant cardiac problem among the study subjects while atrial septal defect (11.1%) was the most common form of congenital heart disease. Based on the NYHA functional classification 74 % were in class I, 22.3% patients were in class II and 2.22 % were in class IV on presentation .28.9 percent deliveries were preterm. The pregnancy duration was shortened in more advanced classes of heart disease. 60% of the cases were delivered by cesarean section. Average birth weight of babies in class I WAS 2.63 +/-0.2 kg, 2.5 +/-0.3 kg in class II, 2.1 kg in class IV. Out of 45, 2 patients had heart failure during the hospital stay. There were 2 perinatal mortalities and one maternal mortality. CONCLUSION: RHD was the predominant type of heart disease in pregnancy and most women were class I at the time of admission. The preterm delivery and cesarean rates were significantly high. A multidisciplinary approach is needed to reduce morbidity, mortality and to optimize the outcome.