Cardiac disease in pregnancy – A retrospective study

Abstract

Objectives: To evaluate the maternal and perinatal outcomes in patients with cardiac disease in pregnancy. Materials and Methods: Medical records of 185 women with heart disease who delivered at ≥28 weeks of gestation from January 2011 to December 2015 at JSS Hospital, Mysuru, were studied. Results: The prevalence of heart disease in pregnancy was 1.76%. There were 77 (41.6%) women with congenital heart disease and 72 (38.9%) with rheumatic heart disease. 61.6% of the women were from rural background, and 38.4% were from the urban areas. Isolated mitral stenosis was the most common defect in those with rheumatic heart disease; and atrial septal defect was the most common congenital lesion seen. 80% of women remained NYHA class I throughout pregnancy. 53 women who underwent corrective procedures prior to, or during pregnancy had a good outcome. The maternal mortality rate was 1.4%. 44 % of women were primigravidas. The incidence of pre term labor was 15%.Vaginal delivery was preferred, and the second stage of labor was cut short with either outlet forceps or the vaccum cup. LSCS under regional anesthesia for obstetric indications was well tolerated. 31% of newborns were of low birth weight (<2.5 kg). Conclusions: Cardiac disease is an important cause of maternal and perinatal morbidity and mortality. Patients with NYHA class I/II had a better maternal and fetal outcome than those with NYHA class III/IV. Surgical correction of the cardiac lesion prior to pregnancy was associated with better pregnancy outcome.