The effect of valvular heart disease on maternal and fetal outcome of pregnancy

Abstract

Pregnancy in women with MS and AS is associated with marked increase in maternal morbidity and unfavorable effect on fetal outcome, which are related to severity of disease. Despite high maternal morbidity, mortality is rare.

Pregnancy outcome in women with heart disease at a tertiary referral teaching center in Northern India

“…34% of the women in our study were in NYHA class III and IV compared to 22.3% in a series by Sawhney H et al 4 Congestive cardiac failure was seen in 8 women (16%) as compared to 38% in the series by Hameed A et al and 20% in the study by Asghar F et al, arrhythmia was seen in 4% of cases, maternal mortality 10%, of which occurred in NYHA class III and IV ,this was in correspondence with Sawhney H et al who reported a maternal mortality rate of 2%, of which occurred in NYHA class III and IV. Overall cardiac complication rate in our study was 15.62% which is very similar to 13% reported by Siu SC et al 1,2,4,5 In our study 85. 6,7 All the women improved by at least one functional class by surgical intervention, compared to 82% in the Chandigarh study Sawhney H et al 4 Elkayam et al has concluded that, PBMV should be done in severe symptomatic women with MS who do not respond to medical therapy.…”

“…8 Preterm labour was seen in 20% in our study. The corresponding incidence in other studies was 14% Asghar F et al, 12% Sawhney H et al and 23% Hameed A et al 1,2,4 In our study, small for gestational age was seen in 16% compared to 18.2% Sawhney H et al and 21%…”

“…Mitral stenosis (MS) was the predominant lesion in many studies Hameed A et al, Sawhney H et al, Asghar F et al being 69.6%, 89.2% and 42% respectively. 1,2,4 In our study also MS was predominant in 50.6 % of the cases. Early detection, evaluation and prevention of precipitating factors are important in reducing complications.…”

“…1,4 There was a significant difference in the perinatal outcome between NYHA class I, II and III, IV in our study. The perinatal mortality rate in our series was 3.5 % in class I and II compared to 14% in class III and IV.…”

“…Despite of continuous advancement in treatment and management of cardio-vascular diseases, it accounts for one third of maternal mortality along with it increases the risk of adverse maternal and foetal outcome. 1 With the availability of modern surgical facilities and advances in medical management (due to advanced equipment and better drugs) along with intensive maternal and fetal monitoring the scenario has quite changed.…”