Publication:

Study of outcome of pregnancy in women with heart disease

Background Heart disease complicates 1% of all pregnancies. Objective of the study is to evaluate the maternal and fetal outcome in patients with cardiac disease in pregnancy.

Methods An observational study was carried out in 25 pregnant women with known or newly diagnosed heart disease at tertiary care hospital.

Results The average age of women was 21-25 (36%), in which primigravida 52% and 48% were multigravida. 56% patients were unbooked and 44% booked. Rheumatic heart disease was the commonest aetiology and was found in 56% of patients. While 16% patients had RHD with PAH. Three (12%) patient had prosthetic valve replacement. 8% patient had Congenital heart disease while 8% had peripartum cardiomyopathy. 60% delivered vaginally and 40% of them had delivered by LSCS for various obstetrical indications. In our study none of the patient required therapeutic termination of pregnancy. Majority of patients 92% in our study group had no obstetric maternal complications. Two (8%) maternal mortality occurred in our study. Low birth weight babies were 24%, preterm labour in 4% patient. 8% babies were growth restricted. Regarding fetal outcome 25 were live birth babies. None of the patient had congenitally malformed baby and there was no perinatal loss in this study.

Conclusions Early diagnosis of heart disease, regular antenatal checkups, institutional delivery and collaboration between cardiologist and obstetrician should result in a fall in maternal deaths from conditions already diagnosed before pregnancy.