Maternal Outcome among Women Having Cardiac Disease at Tertiary Care Hospital

Aim: To determine the maternal outcome among women presented with cardiac disease at tertiary care hospital. Study design: Prospective study. Place and duration of study: Department of Obstetrics & Gynaecology, Liaquat University of Medical and Health Science Jamshoro from 1st April 2019 to 31st March 2020. Methodology: Fifty-seven women after 24 weeks of alive pregnancy and having cardiac diseases were included. The subjects were seen in the Gynaecology OPD every two weeks till 34-36 weeks, as per institutional protocols and after that every week by obstetrician. Cardiologists saw subjects in each trimester and delivery schedule were developed and medications were adapted with collaboration. The anaesthetic scheme of the subject was also reviewed with the cardiac anaesthetist. All the maternal outcome data was recorded. Results: Most of the patients 89.5% had age group of 25-32 years. Multiparous women were commonest 43.3% and 53.7% patients underwent normal vaginal delivery. 35.8% patients had congenital heart disease, 32.8% had cardiomyopathy and 16.4% had Rheumatic heart disease. According to the maternal outcome anemia was most common among 85.1%, pre-eclampsia 41.8%, pulmonary edema 35.8%, IUGR 20.9%, birth asphyxia 26.9%, preterm 38.8% and maternal mortality 14.9%. Abruption placenta and preterm birth were significantly associated with congenital heart disease and cardiomyopathy p=0.047 and p=0.002 respectively. Pulmonary edema was higher among patients of cardiomyopathy (p=0.027). Birth asphyxia was higher among patients of rheumatic heart disease. While anemia, IUGR and maternal mortality were equally found among cardiac diseases, p-values were quit insignificant. Conclusion: Cardiac disease showed adverse maternal outcome during pregnancy with mortality rate of 14.9%.