Abstract
The aim of this retrospective cohort study was to evaluate the pregnancy outcome following open heart surgery for three years. Group I (n = 37) included pregnancy with history of intracardiac repair except valvular heart disease, while Group II (n = 19) included pregnancy with prosthetic valve received anticoagulation therapy. In total, 78.6% pregnancies ended in healthy live births, and 19.6% pregnancies terminated in abortion (8.1% patients in Group I and 42.1% patients in Group II). 5.3% baby was born with congenital malformation in Group II. Mean birth weight was found 2.8 ± 0.6 kg in Group I and 2.5 ± 0.3 kg in Group II. The mean APGAR score was found 8.5 ± 0.7 in Group I and 8.1 ± 0.7 in Group II. 19.6% patients developed cardiac complications during the pregnancy. Majority of the patients (89.2% in Group I and 63.2% in Group II) was found good health status. Proper antenatal care and early risk stratification are the fundamental measures to improve the maternal and fetal outcome in a patient of open heart surgery.
Highlights
The primary cause of non-obstetric mortality in pregnancy is the cardiac disease
Regardless of the occurrence of the cardiovascular diseases and pregnancy reduced throughout the latest decades, the rate of cardiac diseases is assessed to occur in 1-4% of pregnancies and valvular pathology especially mitral valve disease is the most common pathology in these cases.[1]
Patients were divided into two groups: Thirty seven pregnant women with the history of intracardiac repair for heart diseases except valvular heart disease were included as Group I, while 19 pregnant women with valvular surgery received anticoagulation therapy throughout the pregnancy were included as Group II
Summary
Though post-operative prognosis after open heart surgery is improved, women still afraid of having babies after open heart surgery. A small number of women with a history of open heart surgery get pregnant, though professional experience in this field shows that if properly managed, outcomes of pregnancies after open heart surgery is encouraging. During pregnancy following physiological changes occurs increase myocardial oxygen demand, increase CO, heart rate, and blood volume, and all of this factor causes functional deterioration in the cardiovascular system in a pregnant woman with heart disease. Cardiac surgery has provided a favorable maternal prognosis in these cases.[2] The hemodynamic changes of pregnancy put extra circulatory burden on the heart, which aggravates during labor and immediately following delivery.[3]
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