A Retrospective Study to Evaluate the Maternal and Fetal Outcome in Patients of Heart Disease in Pregnancy at a Tertiary Rural Hospital

Abstract

Background: Heart disease(HD) in pregnancy remains an important cause of maternal, fetal morbidity and mortality especially in a developing country like India, where incidence of cardiac disease that complicates pregnancy is between 1% to 4% & Rheumatic heart disease (RHD) still remains the most common type of heart disease complicating pregnancy due to Poor socioeconomic condition. Methods: This is a retrospective observational study carried out in Department of Obstetrics and Gynaecology at S.M.B.T. Institute of medical sciences, Dhamangaon during the period of 24 months to assess the maternal and fetal outcome on patients of heart disease with pregnancy. Result: Among the 3182 patients delivered in the study 35 had cardiac disease with prevalence of 1.1%, all patients were booked and diagnosed with heart disease during ANC checkup. Rheumatic Heart disease (70%) was the commonest form of heart disease with MS with MR predominating (22%). NYHA grade 2 patients (41%) were maximum with Anemia as the associated complicating factor.4 patients with severe MS required balloon mitral valvotomy (BMV) of them 1 patient went into pulmonary edema. There was no maternal mortality. 2 patients underwent medical termination of pregnancy (MTP) for cardiac reason and there was 1 neonatal mortality. Conclusion: RHD is still the commonest heart disease in pregnancy; BMV can be performed in third trimester on patients with severe MS reducing intra and postpartum complications. Giving good and timely antenatal, Intranatal and postnatal care at a tertiary care hospital with good cardiac, obstetric & Neonatal care setup reduces maternal and fetal morbidity in patients of heart disease with pregnancy. Keywords: Rheumatic heart disease in pregnancy, Congenital heart disease in pregnancy, Balloon Mitral Valvotomy in pregnancy