Abstract
Background: Cardiac disorders complicate 1 to 4% of pregnancies. Women with cardiac disorders have a risk during pregnancy, labor, postpartum. It is essential to prevent cardiac disorders, if not prevented, diagnose and provide timely appropriate management to prevent deaths. Objective: To know the trends and frequency of disorders, feto-maternal outcome in women with cardiac disorders complicating pregnancy in limited resource settings. Material and Methods: Analysis of case records of women with cardiac disorders managed from 1987 and 2016 was done. During this study period, 79868 women delivered, 576 women with cardiac disorders were hospitalized in the Obstetrics department. The analysis was done after getting information related to objectives. Results: Of 576 women who were admitted with cardiac disorders, 56 had an abortion, 20 were lost to follow up. The feto-maternal outcome of 500 cases was analyzed. 376 (75.2%) women had normal delivery, 72 (14.4%) instrumental and 52 (10.4%) women underwent Caesarean Sections (CSs). Perinatal Mortality Rate (PMR) was 40.9 and 16 (2.87%) of 556 women died, contributing to 9.5% indirect maternal mortality during the period of analysis. However, the outcome has been improving over the years. Conclusion: Pregnancy in women with heart disease is associated with significant cardiac and neonatal morbidity. Over the years, it has been found that pregnancy complicated by heart disease can result in a favorable outcome for both mother and fetus, provided meticulous care is taken before and during pregnancy, labor and postpartum period with appropriate therapy.
Highlights
Cardiac disorders complicate 1 to 4% of pregnancies
Most cases were diagnosed in antenatal outpatient, some did present as emergency cases either during pregnancy or labor and some even in the postnatal period
Fetomaternal outcome could be analyzed for 500 cases (434 Rheumatic Heart Disease (RHD), 59 Congenital Heart Diseases (CHDs), and 07 cardiomyopathies)
Summary
Cardiac disorders complicate 1 to 4% of pregnancies. Women with cardiac disorders have a risk during pregnancy, labor, postpartum. It has been found that pregnancy complicated by heart disease can result in a favorable outcome for both mother and fetus, provided meticulous care is taken before and during pregnancy, labor and postpartum period with appropriate therapy. Better diagnostic modalities and management are enabling more girls with Congenital Heart Diseases (CHDs) survive, increasing the number of pregnant women with CHDs, with their risks Because of symptoms such as, breathlessness or signs such as, an ejection systolic murmur which suggests heart disease, may be present in up to 90% of the pregnant women as a consequence of the physiological changes induced by pregnancy itself, there are problems in diagnosis as well as management of cardiac disorders
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