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

Salam, Samia; Mushtaq, Saba; Mohiuddin, Khalid; Gul, Irfan; Ali, Asifa

doi:10.18203/2320-1770.ijrcog20174041

Cited by 14 publications

(19 citation statements)

References 17 publications

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“…We found that, despite mothers suffering from heart disease, most of their pregnancies are full-term (the term “pregnancy” was defined as a live birth from 37 completed weeks to less than 42 completed weeks of gestation [17]). Furthermore, in this study, overall, RHD was much more common than CHD, which was consistent with previous studies [18,19,20,21]. The explanation for this can be due to the lack of preventive treatment and inadequate use of secondary antibiotic prophylaxis against streptococcal infections in Vietnam.…”

Section: Discussionsupporting

confidence: 91%

“…We found that mitral valve regurgitation was predominantly due to valvular lesions (40.12%). However, most previous studies indicated that mitral valve stenosis was more common [15,18,19,20,21,22]. The reason might be that our study only concentrated on pregnant mothers after 22 weeks of gestation, whereas others included mothers over the whole pregnancy period.…”

Section: Discussionmentioning

confidence: 96%

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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: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 96%

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

Thắng

Van

Thi

et al. 2019

IJERPH

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“…Mortality in pregnant females with cardiac diseases is mainly due to cardiac failure and pulmonary oedema. In our study out of 100 patients 2 were died due to cardiac failure and sepsis which was comparable to the study done by Saima Salam 12 and Kamat. 13 Both were of term gestation and one was delivered vaginally developed peripartum cardiomyopathy and the other a known case of congenital heart disease delivered through caesarean section.…”

Section: Discussionsupporting

confidence: 88%

Clinical Study of Cardiac Diseases during Pregnancy in a Tertiary Care Center, Kakinada

Kothapalli¹,

Akkamamba²,

Medapati³

et al. 2019

jemds

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A B S T R A C T BACKGROUNDCardiovascular abnormalities are considered to be the most important non obstetric cause of morbidity. The primary objective of the present study is to assess the effect of heart diseases in pregnancy and its outcome. If diagnosed early and managed properly with multidisciplinary team approach, collaboration of trained obstetrician, cardiologist, anaesthetist, paediatrician and nurse, it results in a successful outcome for mother and child in majority of cases. The primary objective of the present study is to assess the effect of heart diseases on pregnancy and its outcome METHODSThe study was carried out in a tertiary care centre, GGH KKD over the period January 2018-January 2019. All antenatal patients having cardiac diseases either previously diagnosed or diagnosed during antenatal visits, early postnatal patients with booked antenatal visits, referrals with cardiac diseases, emergency admissions, patients who developed cardiac complications during peripartum period were included in the study. Data was statistically analysed SPSS 16. RESULTSOut of a total of 10936 admissions in our hospital during the study period, there were 135 admissions with heart disease complicating pregnancy (1.23%). 100 of them were included in the study. The RHD (40%) was the principal cause of heart diseases among all the pregnancies. Second common cause is congenital heart diseases. Of these, 26% underwent cardiac surgery. Peripartum cardiomyopathy was found in 6% of patients. CONCLUSIONSThis study concluded that pre pregnancy diagnosis, counselling appropriate referral, routine antenatal supervision, and delivery at an equipped centre improve the foetomaternal outcome in pregnancy with heart disease.

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“…Peripartum cardiomyopathy (40.9%) was the leading cause of cardiac morbidity in our study, and it was the only cause of cardiac-related maternal mortality. That was unlike in most parts of India, where rheumatic heart disease and congenital heart diseases were the leading cause of morbidity and mortality [ 27 - 28 ]. It may be because most of the valvular heart diseases were diagnosed early in the pregnancy and hence optimized adequately before delivery, whereas cardiomyopathies are usually diagnosed late.…”

Section: Discussionmentioning

confidence: 99%

Maternal Near-Miss as a Surrogate Indicator of the Quality of Obstetric Care: A Study in a Tertiary Care Hospital in Eastern India

Singh¹,

Barik²

2021

Cureus

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Background Monitoring severe acute maternal morbidity or maternal near-miss is currently proposed by WHO as a valuable tool to assess the quality of obstetric care and implement new strategies for improving maternal health. Aim and objective The objective of this study was to assess and analyze the incidence of maternal near-miss (MNM) and maternal death (MD) at Tata Main Hospital, Jamshedpur, a tertiary care hospital in eastern India. Material and method This study was a prospective observational study conducted at Tata Main Hospital from November 2016 to October 2019. The study population included all the pregnant women who fulfilled the WHO near-miss criteria based on organ dysfunction or failure and all the maternal deaths that occurred during the study period. Results During the study period, there were 15,377 deliveries and 14,636 live births. The MNM cases were 153, and 38 were maternal deaths. The maternal near-miss ratio (MNMR) and severe maternal outcome ratio (SMOR) were 19.9 and 13.1 per 1000 live births, respectively. The maternal near-miss to mortality ratio (MNM: 1 MD) was 4:1, and the mortality index (MI) was 19.9%. Haemorrhagic disorders were the leading cause (40.5%) of MNM, followed by hypertensive disorders (25.5%) and cardiac diseases (14.4%). Similarly, both haemorrhage (23.7%) and sepsis (23.7%) were the leading causes of death followed by hypertensive disorders (15.8%). On reviewing patients, 62% of near-miss and 92% of mortality cases had shown organ dysfunction on admission. Conclusion MNM and MD cases share similar pathology with a different outcome. Hence, monitoring a larger volume of MNM cases helps in identifying the causes of maternal adverse events and finding out the gaps in the management more effectively than auditing only the maternal deaths.

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

Cited by 14 publications

References 17 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

Clinical Study of Cardiac Diseases during Pregnancy in a Tertiary Care Center, Kakinada

Maternal Near-Miss as a Surrogate Indicator of the Quality of Obstetric Care: A Study in a Tertiary Care Hospital in Eastern India

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