When Two Hearts Beat as One: A Prospective Observational Study on Maternal and Fetal Outcomes in Cardiac-Complicated Pregnancies From a Tertiary Centre in South India

Background: Cardiac disease is a significant non obstetric cause of maternal morbidity and mortality. Physiological changes of pregnancy may unmask or exacerbate underlying cardiac disease. To assess maternal and fet Objective: al outcomes in pregnancies complicated by heart disease. A prospective observational study was conducte Methods: d at the Institute of Obstetrics and Gynaecology, Madras Medical College, Chennai from July 2022 to July 2023. A total of 110 antenatal women with pre existing or newly diagnosed cardiac disease were included. Detailed clinical evaluation, transthoracic echocardiography, risk assessment using NYHA and modified WHO classification, and peri partum monitoring were performed. Maternal and neonatal outcomes were analysed. Most Results: patients were aged 19-25 years (41.82%, n=46) and were primigravida (61.82%, n=68). Term deliveries occurred in 78.18% (n=86). Rheumatic heart disease (71.6%, n=79) was the most common aetiology, followed by congenital heart disease (21%, n=23) - predominantly ostium secundum atrial septal defect. Vaginal delivery was achieved in 56% (n=62) and forceps-assisted delivery was required in 22.8% (n=25). Preterm deliveries occurred in 7.27% (n=8) and there was one stillbirth (0.91%). Neonatal outcomes included 16.36% (n=18) NICU admissions and 2.73% (n=3) neonatal deaths; no neonatal congenital cardiac anomalies were detected. Two maternal deaths occurred due to Ebstein’s anomaly and Eisenmenger syndrome. Pregnancy with cardiac disease requires multidisciplinary management. Earl Conclusion: y diagnosis, vigilant monitoring, and collaborative care between obstetricians, cardiologists, and anaesthesiologists are essential to optimise maternal and neonatal outcomes.