Key result
Maternal heart disease during pregnancy was predominantly rheumatic (62%), with 21% of patients experiencing cardiac complications, a 3% maternal mortality rate, and 58% of babies born with low birth weight.
Why the study?
Cardiac disease is a leading cause of maternal mortality and morbidity, and timely diagnosis and management can significantly improve maternal and perinatal outcomes.
Observational (n=100)
No
In pregnant women with cardiac disease in India, rheumatic heart disease remains the most common etiology, and multidisciplinary management is essential to address the high rates of cardiac complications (21%) and maternal mortality (3%).
Substantial maternal-neonatal risks in cardiac pregnancies warrant multidisciplinary teams; leaves open optimal protocols in high-prevalence regions.
Background: Cardiac disease is a leading cause of maternal mortality and morbidity. Timely diagnosis and appropriate management can significantly improve the maternal and perinatal outcome.Methods: This prospective observational study was performed over a period of 18 months at a tertiary care centre in Mumbai. A total of 100 women with heart disease were included in the study. The subjects were followed up during the antenatal, intrapartum and postpartum period to study the maternal and perinatal outcome.Results: Out of 14791 confinements 100 consenting patients were included in the study. The incidence of heart disease came out to 0.9%. Rheumatic heart disease (RHD) was seen more commonly as compared to congenital heart disease (CHD) and peripartum cardiomyopathy. 64% patients delivered vaginally out of which 8% had instrumental delivery and 28% underwent a lower segment caesarean section (LSCS). 21% patients had cardiac complications like pulmonary edema, arrhythmias, sepsis, DIC etc. and there were 3 maternal mortalities. 58% of the babies were born low birth weight, 90.9% of the babies had an Apgar score of >7. 60% of the babies were born at term whereas 26% had a preterm delivery.Conclusions: Patients of cardiac disease with pregnancy need to be managed at a tertiary care centre by a multidisciplinary team of doctors. Early diagnosis of heart disease and stringent management of complication is of utmost importance. Vaginal delivery is favourable and LSCS should be performed for an obstetric indication. Maternal heart disease leads to an increased incidence of preterm delivery and hence a joint care of neonatologist is mandatory in managing these patients.
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Kamble et al. (2018) conducted an observational in Pregnancy with cardiac disease (n=100). Maternal heart disease was evaluated on Maternal and perinatal outcomes. Maternal heart disease during pregnancy was predominantly rheumatic (62%), with 21% of patients experiencing cardiac complications, a 3% maternal mortality rate, and 58% of babies born with low birth weight.
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