The delivery mode of pregnancy complicated with heart disease and its effect on the prognosis of neonates

Abstract

Objective To analyze the delivery mode of pregnancy complicated with heart disease and its effect on the prognosis of neonates. Methods Sixty-three pregnant women with heart disease admitted to Jiaozhou Maternal & Child Health Hospital from February of 2016 to June of 2017 were divided into two groups according to NYHA classification, including class Ⅰ-Ⅱ group (39 cases) and class Ⅲ-Ⅳ group (24 cases). Outcomes (incidence of vaginal delivery, cesarean section and heart failure), neonatal outcomes (incidence of preterm birth, incidence of intrauterine growth retardation, Apgar score, birth weight) were compared between two groups. Results Among 63 pregnant women with heart disease, the top three types of heart disease were congenital heart disease (38.10%), arrhythmia (22.22%) and rheumatic heart disease (15.87%). The vaginal delivery rate of grade Ⅰ-Ⅱ group was 23.08%, higher than that of grade Ⅲ-Ⅳ group (0.00%), and the cesarean section rate was 76.92%, lower than that of grade Ⅲ-Ⅳ group (100.00%). The incidence of heart failure was 0.00% in grade Ⅰ-Ⅱ group, lower than that of grade Ⅲ-Ⅳ group (20.83%) (P<0.05). The incidences of premature delivery and intrauterine growth retardation in grade Ⅰ-Ⅱ group were lower than those of grade Ⅲ-Ⅳ group, and the Apgar score and birth weight in 1 min were higher than those in grade Ⅲ-Ⅳ group (P<0.05). Conclusion Congenital heart disease is the main type of pregnancy with heart disease, and NYHA classification is closely related to maternal pregnancy outcomes and neonatal prognosis. The higher the heart function classification, the higher the risk of adverse pregnancy events. The indications of vaginal delivery can be relaxed appropriately for pregnancy with NYHA graders Ⅰ-Ⅱ, and cesarean section should be performed to terminate pregnancy for NYHA graders Ⅲ-Ⅳ. Key words: Neonatal; Prognosis; Pregnancy; Heart disease; NYHA classification; Delivery mode