Maternal and fetal outcome in patients of heart failure at a tertiary care centre

Abstract

Background: To study maternal and fetal outcome in antenatal patients with heart failure. Methods: The present study was conducted on pregnant female with heart failure admitted to hospital UISEMH, Kanpur from January 2012 to August, 2013. We attended 6800 pregnant female admitted to hospital out of which 48 pregnant female had heart failure during pregnancy or in labour. This was descriptive observational study. Results: Percentage of pregnant female with heart failure in our study was 0.7%. The mean of age distribution in pregnant patients with heart failure is 22.66 ± 2.82 years. Primigravida and primipara contributed to major group with 77.09% (37/48). Delivery was conducted in 33.3%, while 60.4% were expired. 4% of cases lost follow-up. None of patient belonged to AHA class A or B of heart failure. 37.5% were in AHA class C while 62.5% were in class D. Early diagnosis was made in only 16.58% of cases. 75% of early diagnosed case survived in comparison to 32% of late diagnosis. 31.25% cases delivered term healthy babies, 37.5% were dead born and pre-term and small for gestation babies are 12.5% and 18.75% respectively. Of dead born 66.6% were macerated and 33.3% were fresh stillbirths. Among survivals 57% had ventilator support. Conclusion: Early diagnosis and prompt management improves outcome. Maternal and fetal outcome is dependent on time of diagnosis, severity of heart failure and ventilator support.

Study of maternal and perinatal outcome of referred patients in tertiary health centre

“…Morsheda Banu et al; in assessing showed that overall age distribution in majority (74%) of the respondents were between 20-35 years. 13 In present study, majority of patients were primigravida (46%), which is comparable. 14 Morsheda Banu et al; had found that around 50% of the women were primigravida.…”

“…The commonest indication of caesarean section amongst referred patients was fetal distress. 13,19 Sorbye et al found that referral status contributed substantially to the increased caesarean section rate, which was 55% in formally referred. 20 In present study, 39% referred cases underwent caesarean section so we can conclude that rate of caesarean section is substantially high in referred cases.…”

“…13,18 The patients with previous caesarean section are referred to higher centers from PHC/CHC due to unavailability of operation theatre, gynecologists, anesthetics, trained staff or basic infrastructure deficits.…”

To study pattern of obstetric cases referred at tertiary care centre in Central India

“…13 56%, 30% and 14% of cases were referred to our hospital in their intrapartum, antepartum and postpartum period respectively. Similar results were found by Devineni K et al 14 in their "Study of spectrum of referral pattern at a tertiary teaching hospital towards better obstetric care".…”

“…13,18 The patients with previous caesarean section are referred to higher centres from PHC/CHC due to unavailability of operation theatre, gynaecologists, anaesthetics, trained staff or basic infrastructure deficits.…”