Maternal and perinatal outcome in cardiac disease complicating pregnancy

Background: Maternal cardiac disease associated with pregnancy is considered as a high-risk pregnancy. Various physiological and hemodynamic alterations during the course of pregnancy make these women prone for various complications and related morbidity and mortality.Methods: A prospective cross-sectional study of 105 cases of pregnancy complicated by cardiac disease, reporting to tertiary care hospital for delivery, was carried out to find out the maternal and perinatal outcome.Results: The incidence of cardiac disease in pregnancy in the present study was 0.54%. Most of the women (91%) belonged to low socioeconomic class. Rheumatic heart lesions constituted 87% of the cases. Mitral stenosis alone or in combination, was the commonest (57%) valvular lesion. Incidence of spontaneous vaginal delivery was 53 percent and for ventose or outlet forceps was 12 percent. Incidence of caesarean section was 35%. There were 2 maternal deaths, one each due to complication like pulmonary oedema and atrial fibrillation. The perinatal mortality was 36 per 1000 live births, mainly due to combination of factors like prematurity, low birth weight, neonatal sepsis and birth asphyxia.Conclusions: Early diagnosis of heart disease, regular antenatal checkup, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease.