CARDIAC DISEASE IN PREGNANCY AND MATERNAL OUTCOME - A RETROSPECTIVE STUDY

Abstract

Objectives : To evaluate the maternal outcomein patients with cardiac disease in pregnancy in terms of maternal complication and mode of delivery. Materials And Methods : Medical records of 50 women with heart disease who delivered at >/= 28 weeks of gestation from March 2018 to February 2022 at Department of Obstetrics and Gynecology ,Basaweshwara Hospital ,attached to MahadevappaRampure Medical college ,Kalaburgi , were studied . Results : The prevalence of heart disease in pregnancy was 1%.There were 6(12%) with congenital heart disease(CHD) and 36(72%) with rheumatic heart disease(RHD), other lesions were 8(16%).76% of the women from rural background , 24% of the women from urban background .Isolated Mitral Regurgitation(MR) was the most common defect in rheumatic heart disease , atrial septal defect is the most common congenital lesion seen.64% of women remained NYHA class I throughout pregnancy. Heart failure developed in 2 patients whose NYHA changed from I/II to III /IV .18 women underwent corrective procedures prior or during pregnancy had good outcome. The maternal mortality was 2%.The incidence of preterm labor was 8%. Majority of the women delivered by spontaneous vaginal delivery 18(36%) while 16(32%) had caesarean section ,14(28%) had instrumental vaginal delivery , 2(4%) had vaginal delivery after induction . Conclusion: Cardiac disease is an important cause of maternal morbidity and mortality. Patients with NYHA class I/II had a better maternal outcome than those with NYHA class III/IV. Surgical correction of the cardiac lesion prior to pregnancy was associated with better pregnancy outcome.