Maternal and Fetal Outcome in Pregnancies with Heart Disease

Aims and objectives 1. To assess the maternal outcome of pregnancies complicated by heart disease. 2. To assess the foetal outcome of pregnancies complicated by heart disease.Study Design: It was a prospective, observational study conducted at department of obstetrics and gynaecology in a tertiary care hospital over a period of two years. Materials and methods:The study was approved by the Institutional ethical committee.All patients who have cardiac disease in pregnancies admitted in obstetrics and gynaecology department of our institute and were willing to participate in the study were enrolled.Those patients who were admitted in our institute in postpartum period and those who were not willing to participate in this study were excluded from the study.Women enrolled in this study were examined during antenatal or peripartum period (depending upon when they first visit our institute) and classified on the basis of New York heart association (NYHA) functional classification.In admitted patients indication of admission, complications associated with heart disease and shift of NYHA class, if any, were noted.Routine tests and special tests like ECG and 2DECHO were done.Fetal well being was also assessed.Mode of delivery and neonatal outcome was recorded according to the proforma.During postnatal period all patients were followed up to discharge from hospital for any obstetrical, cardiac and neonatal complications.Details of maternal and neonatal morbidity and mortality were noted.Results: in this study the incidence of heart disease was found to be 0.69%.Mean age at presentation was found to be 24 +/-3.4years.Maximum patients belonged to age group 21-25 years.Majority of the patients (77%) were primigravida.Most of the patients (31.46%) were admitted in hospital during 34-37 weeks of gestation.The most common complaints for which the patients were admitted was breathlessness (58.87%) and labour pains (22.58%).A NYHA based classification revealed that most of the patients (70.96%) were NYHA grade I while grade II, III and IV were 13.7% ,11.31% and 4.03% respectively.Most common etiology of heart disease in studied subject was found to be rheumatic (66.94%) in origin followed by congenital (24.19%) and peripartum cardiomyopathy (5.66%).In patients having rheumatic valvular heart disease most common isolated valvular involvement was seen in the form of mitral stenosis (14.5%) followed by mitral regurgitation (6.45%) and tricuspid regurgitation (5.64%).Rest of the patients had multiple valvular lesions involving mitral,tricuspid and aortic valves.In patients who had congenital heart disease most common www.jmscr.igmpublication.org