Key result
The CARPREG II risk prediction index showed no significant difference between observed and expected primary maternal outcomes (p=0.9), though it overestimated risk in patients with scores <3.
Why the study?
The study was conducted to assess the efficacy of the CARPREG II risk prediction index in predicting poor maternal outcomes in pregnancies with heart diseases.
Does the CARPREG II risk prediction index accurately predict poor maternal outcomes in pregnant women with structural heart diseases?
Observational (n=66)
No
Does the CARPREG II risk prediction index accurately predict poor maternal outcomes in pregnant women with structural heart diseases?
p-value: p=0.9
The CARPREG II risk prediction index is effective at predicting maternal adverse clinical events in pregnant women with structural heart disease, although it may overestimate risk in lower-risk patients (score <3).
May inform maternal risk stratification in structural heart disease; leaves open prospective validation and low-score recalibration.
The aim of the study was to assess efficacy of CARPREG II risk prediction index in predicting poor maternal outcomes in pregnancies with heart diseases. Materials and methods: This study was conducted in the department of obstetrics and gynecology at a tertiary care center in Mumbai. This was a retrospective study of 66 pregnant women with structural heart diseases. CARPREG II score was calculated for each patient as per history, clinical examination, specific lesion through echo findings, and delivery of antenatal care. Primary and secondary adverse cardiac outcomes were noted during antepartum and postpartum periods. Obstetric and perinatal outcomes were also recorded. Results: Mean age of the study population was 27.36 years. A total of 51.5% (n = 34) patients were primigravidae. Majority of the subjects about 59.09% (n = 39) had rheumatic heart diseases (RHDs) and 25.75% (n = 17) had congenital heart diseases (CHDs). Overall, vaginal delivery was the most common route with an increased rate of Cesarean section (41.07%) and instrumental vaginal delivery (16.6%). There was no significant difference in observed and expected values of primary maternal outcome (p value = 0.9). All the maternal adverse clinical events were more common in groups of patients with CARPREG II index of 4 or more, but in score <3, the risk index overestimated maternal adverse cardiac events. Perinatal complications did not show any correlation with CARPREG II score.
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Lewis et al. (2021) conducted an observational in pregnancies with structural heart diseases (n=66). CARPREG II risk prediction index was evaluated on primary maternal outcome (p=0.9). The CARPREG II risk prediction index showed no significant difference between observed and expected primary maternal outcomes (p=0.9), though it overestimated risk in patients with scores <3.
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