Assessment and Evaluation of the Woman With Cardiac Disease During Pregnancy

Dobbenga-Rhodes, Yvonne A.; Privé, Alice M

doi:10.1097/00005237-200610000-00007

Cited by 18 publications

(16 citation statements)

References 22 publications

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“…In developed countries, there has been a reduction in the incidence of pregnancies complicated by RHD. However, in developing countries, RHDs are not only still prevalent but continuously a major reason resulting in morbidity and mortality in pregnant mothers [6,7].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy with Heart Disease: Maternal Outcomes and Risk Factors for Fetal Growth Restriction

Thắng

Van

Thi

et al. 2019

IJERPH

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Caring for children and mothers suffering from cardiac disease is highly challenging, with issues including late diagnosis as well as inadequate infrastructure and supply of drugs. We aimed to evaluate maternal outcomes among pregnant women suffering from heart disease with a live birth, and explored the risk factors for fetal growth restriction among these patients. A retrospective study was performed at the National Hospital of Obstetrics and Gynecology (Hanoi, Vietnam) over a 3-year period from 2014 to 2016. A total of 284 patients were enrolled in the study. Overall, most women were aged below 35 years and were diagnosed with heart disease before pregnancy. Of the women experiencing rheumatic heart disease, the prevalence of mitral valve regurgitation was the highest (40.14%), while the figure for aortic valve regurgitation was the lowest (4.23%). Of women with congenital heart defects, the most common defects were ventricular septal defect (VSD) and atrial septal defect (ASD) (19.37% and 16.55%, respectively), while 5.28% of mothers were diagnosed with tetralogy of Fallot and 1.76% with patent ductus arteriosus. Noted clinical presentations of the patients included palpitation (63.38%), breathlessness (23.59%), leg edema (8.45%), and chest pain (8.1%). The common complications in the study population included 16.90% of women having heart failure and 19.37% having arrhythmias. The incidence of fetal growth restriction was 9.15%. Hypertension (odds ratio (OR): 59.75, 95% confidence interval (CI): 9.1–392.17), the heart disease types (ASD (OR: 4.27, 95% CI: 1.19–15.29) and tetralogy of Fallot (OR: 6.82, 95% CI: 1.21–38.55)), and the complications (heart failure (OR: 10.34, 95% CI: 2.75–38.87) and pulmonary edema (OR: 107.16, 95% CI: 4.96–2313.93)) were observed as risk factors for intrauterine growth restriction. This study provides a cornerstone to promote further studies and to motivate people to apply evidence-based medical care for mothers with diagnosed cardiac disease in the antenatal and postnatal periods.

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Section: Introductionmentioning

confidence: 99%

Pregnancy with Heart Disease: Maternal Outcomes and Risk Factors for Fetal Growth Restriction

Thắng

Van

Thi

et al. 2019

IJERPH

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“…In western countries, maternal heart diseases are the third most common cause of maternal death and complicates 1-3% of pregnancies. 7,8 Cardiac diseases can complicate 1-4% of pregnancies in women without pre-existing cardiac abnormalities. Cardiac disease is one of the three major indirect causes of maternal mortality in India.…”

Section: Introductionmentioning

confidence: 99%

Maternal and fetal outcome in pregnancy with heart disease in tertiary care hospital in India

Salam¹,

Mushtaq²,

Mohiuddin³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Cardiac disease is an important cause of maternal mortality and morbidity both in antepartum and postpartum period. The overall incidence of heart disease in pregnancy is <1%. Objective of present study was to determine maternal outcome in pregnant women with heart diseases in terms of fetal complication, maternal complication and Mode of delivery.Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Government Lalla Ded Hospital, an associated of Government Medical College, Srinagar which is the sole tertiary care referral centre in the valley. 90 women with heart disease which were previously established or diagnosed during pregnancy were enrolled in the study.Results: In 90 women pregnancies was complicated by heart disease in the study. The prevalence of heart disease amongst all pregnancies found in hospital was 4.3%. The principal cause of cardiac lesion was Rheumatic heart disease (RHD) (56.6%) while congenital heart disease was seen in 13.3%. Among the women who had RHD, mitral stenosis seen in 21 (23.3%) was most common lesion and Multiple cardiac lesions 21 (24.4%) women. Among the women with congenital cardiac disease, mitral valve prolapse was most common constituting 5 (5%) cases. Cardiomyopathy was the most common constituting 7 (7.3%). Heart failure developed in 10 (11.1%) whose NYHA class changed from class I/II to class III/IV. Majority of the women delivered by caesarean section 33 (36.7%) while (35.6%) had a normal vaginal delivery with spontaneous onset of labour. 7% had assisted instrumental vaginal delivered. 9% women had first trimester abortion. There were 4 maternal deaths. 85.6% live births were observed in these women. No baby had congenital heart disease. 72.8% babies born weighed more than 2kg.Conclusions: This study concluded that pre- pregnancy diagnosis, counselling, appropriate referral, antenatal supervision and delivery at equipped centre improve the pregnancy with heart disease outcome for both mother and baby.

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“…As a result, pregnancy becomes a realistic option for many of these young women. In western countries, maternal heart disease complicates 1-3% of pregnancies and is the third common cause of maternal death during pregnancy [1,2].…”

Section: Introductionmentioning

confidence: 99%

Maternal heart disease and pregnancy outcome: A single‐centre experience

Stangl

Schad

Gossing

et al. 2008

European J of Heart Fail

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Background: Maternal and neonatal complication rates are increased in pregnant women with heart disease. Cardiac risk assessment may be improved by defining low and high-risk groups. Aims: To analyze pregnancy risks in low and high-risk women with cardiovascular diseases. Methods and results: Pregnancy outcomes were analyzed in 93 consecutive women with heart disease, monitored in a single-centre cohort between 1996 and 2006. Women were classified according to pre-defined risk predictors as high-risk (left ventricular [LV] ejection fraction b 50%, NYHA class N II or cyanosis, peak LVoutflow gradient N 60 mmHg) or low-risk (not meeting these criteria). Mean age was 28.1± 5.7 years. 81.7% presented with congenital, 10.8% with acquired heart disease, and 7.5% with myocardial diseases. Severe maternal complications developed in 12.9% of all women: 6.5% heart failure, 3.2% arrhythmias, and 2.2% thrombotic complications. Maternal mortality was 1.1%. Women at high-risk (24.7%) had a 6.1-fold higher maternal complication rate and a 6.1 times higher foetal/neonatal event rate (abortion and stillbirth). 64.7% of the high-risk women delivered prematurely, before the 37th week, compared to 16.4% in the low-risk group. Conclusions: Despite pronounced clinical variability of congenital and acquired heart diseases, a small number of risk conditions can effectively characterize women in whom pregnancy is associated with appreciably increased maternal and foetal risk.

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Assessment and Evaluation of the Woman With Cardiac Disease During Pregnancy

Cited by 18 publications

References 22 publications

Pregnancy with Heart Disease: Maternal Outcomes and Risk Factors for Fetal Growth Restriction

Pregnancy with Heart Disease: Maternal Outcomes and Risk Factors for Fetal Growth Restriction

Maternal and fetal outcome in pregnancy with heart disease in tertiary care hospital in India

Maternal heart disease and pregnancy outcome: A single‐centre experience

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