A CLINICAL STUDY OF MATERNAL AND PERINATAL OUTCOME OF CARDIAC DISEASES COMPLICATING PREGNANCY IN A TERTIARY CARE HOSPITAL

Dr. ROHINI D K; Dr. VARUN G HUILGOL; Dr. PADMA B R; Dr. GOPALKRISHNA B HUILGOL

Volume : IX, Issue : VI, June - 2020

A CLINICAL STUDY OF MATERNAL AND PERINATAL OUTCOME OF CARDIAC DISEASES COMPLICATING PREGNANCY IN A TERTIARY CARE HOSPITAL

Dr. Rohini D K, Dr. Varun G Huilgol, Dr. Padma B R, Dr. Gopalkrishna B Huilgol

Abstract :

Introduction:The incidence of Cardio Vascular Disease in pregnancy has remained stable for many years since the significant decrease in RHD is compensated by increase in CHD in pregnant women. Population based studies have reported incidence of CVD in pregnancy varies between 0.1 to 4% and Cardiac disease remains a significant cause of non obstetric morbidity and mortality during pregnancy. Methods :It is a prospective observational study conducted on 50 pregnant women with cardiovascular disease >28 wks gestation admitted for labour to VVH attached to BMCRI, Bangalore between the period of July, 2013 to August 2014. The essential information of the patients studied was gathered and recorded in the detailed proforma. The maternal complications, related to the cardiac disease and obstetric complications, the perinatal outcome of the cases were analysed. Results :Out of 50 cases in the study Cardiac Disease was found to complicate 0.22% of pregnancy, RHD complicated about 46% and CHD: 44%, with isolated MS: 20%, ASD: 20% being the predominant lesion. The mean duration of onset of Cardiac Disease was 3.5 years, 64% of patients belong to NYHA class II and 16% belong to XIV class I. 32% of patients had undergone Cardiac Intervention before pregnancy. Mean gestational age of delivery was 38 wks(78%) and 82% of them had spontaneous onset of labour and 18% of them had induction of labour. 50% had spontaneous vaginal delivery and 32% had C.Section with 6% instrumental delivery. CCF and Pulmonary HTN were the two main complications with 14% and 10% respectively. One maternal death due to acute pulmonary oedema secondary to RHD with MV repair. 10% of patients had PPH , the main obstetrical complication. The incidence of pre term delivery was 12% and term delivery 88%, and 54% of babies weighed 1.5–2.5kg, live birth rate: 96%, still birth: 4%, NICU admission: 18% , 4% of PNM and 4% of CHD of new born was seen. Interpretation and Conclusion: Majority of women with Cardiac Disease in pregnancy can have a safe pregnancy and delivery provided proper medical care is given. The maternal and perinatal outcome in these patients depends mainly on the functional cardiac status of the mother at the time of pregnancy. The risk of maternal and perinatal morbidity is greater in these patients with functional class of NYHA class III and IV. Surgical correction of the cardiac disease before pregnancy has a better maternal and perinatal outcome and they can tolerate pregnancy well.