Maternal heart disease and pregnancy outcome: Findings from a retrospective cohort in a tertiary care government hospital in Haldwani, Nainital

Joshi, Godawari; Joshi, S. C.; Jha, Sanjay Kumar; Singh, Yatendra; Joshi, Arun

doi:10.4103/0189-7969.152027

Cited by 8 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%

“…They found that 31% of cases experienced a cardiovascular event, and the cardiac events of either heart failure or arrhythmias were the most prevalent among pregnant women [18]. Our result was also in line with Joshi’s study, which reported that heart failure was considered as a common complication among 42 women with cardiac disease [19]. However, the complications including arrhythmias and pulmonary edema were not recorded in Joshi’s study.…”

Section: Discussionsupporting

confidence: 89%

“…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: Discussionsupporting

confidence: 89%

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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“…Similar findings were seen in the study conducted by Joshi et al where in congenital lesions, atrial septal defect was present in 50% cases (3 cases). 11 In our study, mitral stenosis is the predominant lesion 13 cases (30.23%). Multiple valve involvement was seen in 21 patients (48.83%).…”

Section: Discussionsupporting

confidence: 47%

Fetomaternal outcomes in pregnancy with different cardiac disease at a tertiary care center in Udaipur

Chaudhary

Sen

2020

Int J Reprod Contracept Obstet Gynecol

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Background: The incidence of maternal cardiac diseases has an adverse effect on pregnancy outcomes. The present study was done the objective to determine the Incidence and distribution of cardiac disease in pregnant patients, to assess mode of delivery and fetomaternal outcome in pregnancy with heart disease patients.Methods: This was a hospital based prospective observational study that include 65 pregnant women with diagnosed cardiac disease or had symptoms and signs suggestive of cardiac disease during the period from January 2018 to December 2019. Baseline data recorded including age, parity, gestational age, cardiac lesions, New York heart association (NYHA) functional class, use of cardiac medications, thorough clinical examination including chest and cardiovascular auscultation, ECG and echocardiographic assessment of left and right ventricular systolic function. Fetomaternal outcome was analysed in the study.Results: The mean age of the patients was 24.33±2.93 years (ranging from 19-36 years). 34 patients (52.30%) were primigravida. Majority (58.46%) cases were from rural area. Majority patients (70.77%) are present between 37-40 weeks of gestational age. Most of patients had vaginal delivery (64.62%). 43 patients (66.15%) diagnosed with heart disease after pregnancy, while 22 patients (33.85%) are diagnosed before pregnancy for heart disease. Neonatal complications were seen in in 35.38% of patients. Cardiac complications were present in 40% of patients. majority of fetal complications are in nonoperated patients (46.15%).Conclusion: The management of pregnant women with cardiac diseases requires multidisciplinary approach to prevent morbidity and mortality. It is necessary to optimize healthcare facilities to obtain maximum maternal and fetal outcome.

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“…H et al, Indira I et al, Joshi G et al and Pujitha KS et al cause of deaths were cardiac complications as CCF, Pulmonary edema and cardiac arrest 5,12,13,19. …”

mentioning

confidence: 99%

Study of heart disease in pregnancy and its effect on maternal outcome

Jain

Sultan

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Heart diseases in pregnant women and has higher incidence of maternal mortality and morbidity and is regarded as risk factor for unfavourable outcome of pregnancy both for the mother and the foetus. Heart disease in pregnancy was found to be second indirect cause contributing to maternal mortality in India.Methods: This study is a hospital based prospective analytical study carried out in the Department of Obstetrics and Gynaecology, Sultania Zanana Hospital, Gandhi Medical College, Bhopal over a period of 1 year from 1st March 2017 to 28th February 2018. Patients were evaluated clinically by both obstetrician and cardiologist and followed all through their hospital stay till discharge.Results: Total 51 cases of heart disease were found during the study period. Incidence of heart disease in our study during study period was found 0.25%. Most patients were unbooked 33(64.71%) and maximum number of patients belonged to NYHA functional class II 24 (47.06%), RHD cases were 4 times more common than CHD. 24 (47.06%) patients had undergone surgical intervention for heart disease. Congestive cardiac failure was most common complication seen. Three maternal deaths were seen. All cases belonged to NYHA functional class III. All 3 cases were unbooked presented first time in labor.Conclusions: We found that pregnancy outcome was good in booked cases with regular checkup by obstetrician and cardiologist, surgically corrected cases and those with NYHA functional class I and II. Hence, joint management by obstetrician, cardiologist, and anesthetist is required to ensure better maternal outcome.

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Maternal heart disease and pregnancy outcome: Findings from a retrospective cohort in a tertiary care government hospital in Haldwani, Nainital

Cited by 8 publications

References 0 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

Fetomaternal outcomes in pregnancy with different cardiac disease at a tertiary care center in Udaipur

Study of heart disease in pregnancy and its effect on maternal outcome

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