Feto-Maternal Outcome in Cardiac Diseases during Pregnancy at VIMS Ballari - A Retrospective Study

Introduction: Cardiac disease in pregnancy is a high-risk pregnancy, which possess a significant challenge to an obstetrician, cardiologist, and neonatologist.It is considered as one of the important concerns resulting in maternal mortality and morbidity in the antenatal and postnatal periods.Hence our study to evaluate feto-maternal outcomes in pregnancy with cardiac disease.Materials and Methods: The present study is a retrospective study conducted in the department of Obstetrics and Gynecology, Vijayanagara Institute of Medical Sciences, Ballari from 1st January 2020 to 30th June 2021.The objective of the study was to determine feto-maternal outcome in pregnant women with heart disease in terms of fetal complications and maternal complications.The information about 30 pregnant women with heart disease which were previously established or diagnosed during pregnancy was collected from the MRD of the hospital, which was carefully studied and analyzed.Results: In our study prevalence of CHD was 23.3% and that of RHD was 43.3%.In other type of heart diseases, majority of the women i.e., 3 (10%) had peripartum cardiomyopathy and 2 each had pericardial effusion and mild MR.NYHA type I and II were most common i.e., 9 (30%) followed by type IV in 7 (23.3%)and type III in 5 (16.7%)Mode of delivery was LSCS in 14 i.e., 46.7% women, vaginal delivery in 13 (43.3%)and instrumental in 3 (10%) women.Maternal death rate in our study was 16.7%.Fetal death rate in our study was 13.3%. There is strong association between type of heart disease and maternal death as well as between type of heart disease and newborn/fetal death in our study (p<0.05). Conclusion: Heart disease in pregnancy is associated with significant maternal and perinatal morbidity and mortality and thus a routine cardiac auscultation in addition to routine obstetric examination in all antenatal women should be done and any suspicion of heart disease should be confirmed by a cardiologist. Pre pregnancy diagnosis, counselling, routine antenatal supervision, delivery at an equipped Centre, early detection and management of cardiac failure throughout the course of pregnancy, labor and puerperium is of prime importance to determine the favorable maternal and fetal outcome in patients with heart disease.