Publication:

Study of maternal and perinatal outcome in women with congenital heart disease

Background Pregnancy induced changes in cardiovascular hemodynamics are generally well tolerated. However, the reversible but prolonged hemodynamic stress of pregnancy can have negative effects on the diseased heart. In our study we studied various uncorrected and corrected congenital cardiac lesions and their antenatal, intrapartum course, their ability to withstand labor and postpartum complications.

Methods Our study was a retroprospective observational cross-sectional study conducted at KEM hospital, Mumbai with enrolment of total 27 subjects over a period of 18 months between August 2020 to December 2021.The study included all the registered and emergency patients either post abortal or post-delivery with congenital cardiac diseases including the ones who were surgically corrected.

Results The present study was conducted to study demographic features and maternal and perinatal outcomes of pregnancy in these women. Majority of the subjects were diagnosed with heart disease at the age more than 20 years (40.74%) and very few at age less than 5 years. In the present study only 7.4% study subjects were aware about pre-marital counselling, and preconceptional counselling. Among the lesions ASD was commonest reported among 51.85% study subjects. ICU admission was required among 11.11% study subjects. Labour analgesia given to only 18.52% study subjects. We did not observe any association between surgically corrected CHD and ICU admissions, postnatal complications, and outcomes, p>0.05.

Conclusions This study concluded that pre-pregnancy diagnosis, counselling, appropriate referral, routine antenatal supervision and delivery at an equipped centre improve the overall outcomes.