Publication:

Profile and outcome of pregnancy with congenital heart diseases: a retrospective study from a South Indian tertiary care hospital

Background Women with congenital heart disease who become pregnant form an important subgroup of pregnancy cardiac disorders. The additional stress of pregnancy represents a further challenge.

Methods This was a retrospective study. Patient records between 2011and 2015 pertaining to 77 pregnant women with congenital heart diseases were analysed.

Results There was only one patient aged more than 35 years. The age of the others ranged from 18 to 35 years. The mean age was 24 years. There was a slight rural preponderance with 43 (55.8%) from rural areas. Majority 49 (63.5%) belonged to lower middle socioeconomic status. 71 (92.2%) had NYHA functional Class I. Two patients of Class II had worsening of their status. There were no cases of Atrial Fibrillation and only 2(2.6%) had CCF.ASD closure was the commonest procedure done24 (31.2%). There were 6 (7.8%)cases of device closure of PDA and no cases of VSD. Anemia and GDM were seen in 4 (5.2%). The commonest period of gestation at delivery was 37-40 in 64 (83.1%). ASD was the commonest type of lesion 42 (54.5%). 36 (46.8%) had spontaneous labour and there were 18 23.4%)caesarians. Previous LSCS was the commonest indication for LSCS. Full term normal vaginal delivery was seen in 45 (88.2%). Majority of the newborns 30 (39%) had a birth weight in the range 2.6-3.0 kgs.

Conclusions There is a significant burden of Heart disease with pregnancy afflicting young rural women and those from lower socioeconomic levels. Higher level of specialised care minimizes poor maternal and fetal outcomes.