Maternal and fetal outcome in cardiac disease complicating pregnancy at a tertiary centre in a rural area

Objective : To evaluate the maternal and fetal outcomes of pregnancies, complicated by cardiac disease in a developing country. Material and Method : A retrospective analysis was carried out in 60 pregnant women with cardiac disease from June 2013 to June 2004 at a tertiary centre in Kolar. Results : In the present study, the incidence of cardiac disease was 0.4%, out of which 33.3% were Congenital Heart Diseases and 66.7% were Rheumatic Heart Diseases. Mitral stenosis was seen in 51.3% of cases, mitral regurgitation alone was seen in 7.8% and with mitral stenosis in 35.9%. Anemia was seen in 50% of cases, pre-eclampsia in 23.7% and preterm labor in 18.4%.Spontaneous vaginal delivery was seen in 50%, induced in 5%, instrumental deliveries in 16.6% and cesarean in 28.4%. Surgical correction for cardiac disease was done in 24 patients (40%) of which 6 were during pregnancy. Cardiac complications were noted in 8 patients, of which 6 had CCF, 1 had pulmonary edema and one had atrial fibrillation. The incidence of small for gestational age was 28.3%. Maternal mortality was 3.3% and perinatal mortality was 6.6%. Conclusions: Heart disease in pregnancy is a high risk condition and has a major impact on pregnancy. Rheumatic heart disease was the predominant cardiac problem in pregnancy. Associated obstetric complications along with lack of knowledge and ignorance regarding the pathology lead to unpleasant obstetric outcome. Maternal and perinatal morbidity and mortality can be reduced with proper antenatal, intrapartum and postnatal care in conjunction with cardiologist and neonatologist.