CARPEG score as predictor of maternal and fetal outcomes in pregnancies complicated by cardiac disease

Abstract

Background: Co-existing cardiac diseases in pregnancy poses unique challenges to anaesthesiologists and obstetricians. Heart diseases are estimated to complicate 1-3% of all pregnancies. It is a major contributing cause of maternal mortality and fetal complications.This study was designed to predict maternal and fetal outcomes in pregnancies complicated by cardiac diseases using Cardiac disease in Pregnancy (CARPREG) score. Aims and Objectives: 1.Predicting maternal mortality and adverse cardiac events during peripartum period using CARPREG score. 2.Evaluating neonatal outcomes in the pregnancies complicated by cardiac diseases. 3.To assess various cardiac conditions complicating pregnancies. Materials and Methods: A prospective observational study was designed to assess maternal and fetal outcomes using CARPREG score in 60 pregnancies complicated by cardiac diseases in the obstetric department of a tertiary care centre in South India between 2019-2021. CARPREG score includes New York Heart Association (NYHA) class, systolic ejection fraction, left ventricular obstruction and history of cardiac events assigning one point for each parameter; maximum being four. CARPREG score is validated for scores 0, 1 and 2 or more than 2 to be associated with cardiac event rates of 5%, 27% and 75% respectively.Results: Rheumatic heart disease (46.66%) followed by congenital heart diseases (31.66%) were the predominant cardiac diseases.