Maternal and perinatal outcome in rheumatic heart disease.
OBJECTIVE
To study the maternal and perinatal outcome of pregnancies complicated by rheumatic heart disease.


METHODS
A retrospective study was carried out in the cardio-obstetric clinic of the Postgraduate Institute of Medical Education and Research, Chandigarh (India) over a period of 13 years (1987-1999) involving 486 pregnant patients with rheumatic heart disease. Maternal and perinatal outcome was reviewed.


RESULTS
Three hundred and four patients (63.3%) had single valve involvement and mitral stenosis was the most predominant lesion (89.2%). One hundred and seventy one (38.6%) patients had undergone surgical correction prior to the onset of pregnancy. One hundred and thirteen patients (22.6%) were identified as NYHA class III-IV. Mitral valvotomy was performed during pregnancy in 48 patients. The incidence of preterm birth and small for gestational age newborns was 12% and 18.2%, respectively. There were 10 maternal deaths, of which eight patients were NYHA III and IV.


CONCLUSIONS
Rheumatic heart disease in pregnancy is associated with significant maternal and perinatal morbidity in NYHA class III-IV patients.
Sawhney
H
H
Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Aggarwal
N
N
Suri
V
V
Vasishta
K
K
Sharma
Y
Y
Grover
A
A
D000328:Adult; D005260:Female; D005865:Gestational Age; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007194:India; D007231:Infant, Newborn; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality / Q000601:surgery*; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000401:mortality / Q000601:surgery*; D012720:Severity of Illness Index