FETO-MATERNAL OUTCOME IN SURGICALLY CORRECTED CARDIAC DISEASE AT A TERTIARY CARE HOSPITAL IN RAJASTHAN

Abstract

Background: Heart disease is a common and serious clinical condition. Most cardiovascular problems in pregnant women arise from pre-existing chronic conditions (rheumatic heart disease, congenital heart disease and hypertensive vascular disease). The incidence of maternal heart disease in (1). India is about 0.5-1% of all pregnancies Rheumatic heart disease forms majority of patients in this group. It cause chronic valvular lesions commonly affecting the mitral and aortic valves. Objective of present study was to evaluate the burden of cardiac diseases in pregnancy in our hospital and maternal and fetal outcome in patients with surgically corrected cardiac disease. Methods:An observational study was conducted at Mahatma Gandhi Medical College and Hospital, Jaipur from January 2020. 50 pregnant women with surgically corrected heart disease over the period were included in the study. Detailed demographic data, type of surgical connection , maternal outcome , mode of delivery and neonatal outcome were analyzed in detail. Result:There were 50 patients of surgically corrected heart disease in our study period out of which 90% were rheumatic heart disease. Mitral stenosis accounted for 90% cases and 82% required BMV , 8% required MVR. Majority of patients 52% belonged to 26-30years of age group. 50% were primigravida. Pregnancy outcome was uneventful in 92% cases. Among maternal outcome , rhythm disorder were found in 4%, thromboembolic phenomena were found in 2% , cardiac failure in 2%, coagulopathy in 2%, PPH in 8%, puerperal pyrexia in 4%. 1 patient died due to cardiac failure with known case of MS with severe pulmonary hypertension. 52% women were delivered by normal vaginal delivery , 18% were forcep deliveries and 20% underwent caesarean section for obstetric indication. In Neonatal outcome, 62% were full term babies, 38% were pre term babies. 96% were live births , 4% were still births , 2% neonatal death. Conclusion:Rheumatic heart disease was predominant type. Patients with NYHAclass I/ II had better fetomaternal outcome. Surgically treated women tolerate pregnancy well. Fetomaternal outcome can be improved with combined care by obstetrician, cardiologist and neonatologist