CLINICAL PROFILE OF RHEUMATIC  MITRAL VALVULAR HEART DISEASE IN PREGNANCY

Dr. Kiran Uttamrao Nandedkar; Dr. Rajendra V. Bhagwar; Dr. Vimlesh R. Pandey; Dr. Ketaki P. Patwardhan; Dr. Rohit S. Herekar

Volume : V, Issue : X, October - 2015

CLINICAL PROFILE OF RHEUMATIC MITRAL VALVULAR HEART DISEASE IN PREGNANCY

Dr. Kiran Uttamrao Nandedkar, Dr. Rajendra V. Bhagwar, Dr. Vimlesh R. Pandey, Dr. Ketaki P. Patwardhan, Dr. Rohit S. Herekar

Abstract :

Background: Rheumatic heart disease is the most frequent acquired heart disease encountered in pregnant women. This study is conducted to study the clinical profile of rheumatic mitral valvular heart disease in pregnancy. Method: It is an observational study done in tertiary care hospital in Miraj, Maharashtra, India in 50 Pregnant patients from October 2012 to October 2013 of either newly diagnosed or previously known case of rheumatic heart disease and are thoroughly examined and investigated with fresh ECG and 2D Echocardiography and subsequently followed up to assess the outcome in these patients. Results: Observations are made with respect to their age distribution, symptoms, signs, gravida, socioeconomic status, complications, and maternal and fetal outcome. Conclusion:1.Maximum patients were in age group of 26–30 years pointing towards high incidence of rheumatic mitral valvular disease in 3rd decade of life. Most of the patients were primigravida. Brethlessness was most common symptom and most common sign was murmur. Maximum patients were in Kuppuswami’s lower class of socioeconomic status. Most commonly encountered lesion is mitral stenosis. Congestive cardiac failure and atrial fiillation are common complications in pregnant rheumatic mitral valvular heart disease. 2. Incidence of maternal complications like congestive cardiac failure, pulmonary thromboembolism was much less in operated group of patients than in non–operated group. This was found to be statistically significant. Also incidence of low birth weight, preterm delivary were also less in patients operated for rheumatic mitral valvular heart disease. Incidence of maternal and fetal complications was much less in operated group of patients and outcome in operated patients was better than non operated patients. 3. Statistically significant correlation was found in incidence of atrial fiillation and size of left atrium. 4. 66% patients delivered by spontaneous vaginal delivery .66.66% babies had normal birth weight. Hence every patients of rheumatic mitral valvular heart disease should be given trial of normal labor. 5. Thromboembolism, stroke and congestive cardiac failure, acute pulmonary edema are common causes of maternal mortality in rheumatic mitral valvular heart disease. Fetal outcome depends on maternal tolerance of cardio vascular instability due to rheumatic mitral valvular heart disease.