A STUDY OF MATERNAL AND FETAL OUTCOME IN CARDIAC DISEASE COMPLICATING PREGNANCY AT A TERTIARY CARE HOSPITAL

Dr. P.S. Jikki Kalaiselvi; Dr. Prema Elizabeth Jeyanthi David; Mr. R. Mothilal

Volume : VII, Issue : II, February - 2018

A STUDY OF MATERNAL AND FETAL OUTCOME IN CARDIAC DISEASE COMPLICATING PREGNANCY AT A TERTIARY CARE HOSPITAL

Dr. P. S. Jikki Kalaiselvi, Dr. Prema Elizabeth Jeyanthi David, Mr. R. Mothilal

Abstract :

BACKGROUND: Cardiac disease complicating pregnancy is an indirect cause of maternal mortality. The incidence of cardiac disease during pregnancy has remained stable for many years even with significant decrease in the occurrence of rheumatic heart disease (RHD) as this decrease is being compensated by significant increase of pregnancy in women with congenital heart disease (CHD). Therefore, in this study we aim to analyze the incidence of cardiac disease in pregnancy and to assess the obstetrical outcome.

METHODS: A retrospective observational cross sectional study carried out in 96 patients with either congenital or acquired heart disease which included both corrected and uncorrected cardiac lesions at a tertiary care hospital during the period of 4 years from July 2011 to July 2015.

RESULTS: In present study the incidence of cardiac disease in pregnancy was observed to be 1.2%. In this study rheumatic etiology accounted for 47.8 of the cases followed by congenital heart disease accounting for 41.7%, myocardial disease for 6.3% and 4.2% of them rhythm disorders. Among the acquired rheumatic heart disease patients, mitral valvular disease accounted for majority of the acquired heart disease and mitral stenosis with regurgitation being the most predominant lesion in this study. Non cardiac complications like anaemia, diabetes, preeclampsia, epilepsy and hypothyroidism were noted. The newly detected heart disease in pregnancy was 10%. The mode of delivery that namely spontaneous vaginal delivery, instrumental delivery and cesarean section were 31.25%,32.3% and 36% respectively. Adverse maternal outcome of cardiac failure, tachyarrythmias and maternal death and adverse fetal outcome of preterm, IUGR, IUD and neonatal death were also noted.

CONCLUSIONS: A cardiac disease had a major impact on pregnancy. It was a multidisciplinary team work to have optimal maternal and foetal outcome in women with cardiac disease. Hence, constant vigilance was required throughout antenatal, intrapartum and postpartum period to avoid adverse outcomes.