title: Pregnancy following cardiac surgery.
abstract: OBJECTIVE
  To determine the pregnancy outcome in women with cardiac disease who have undergone cardiac surgery.
  
  
  METHODS
  Prospective study in a tertiary care hospital.
  
  
  METHODS
  One hundred and thirteen pregnant women who had cardiac surgery due to valvular disease (commisurotomy as well as valve replacement), or other cardiac defects. These women were followed up in 170 pregnancies between January 1990 and December 1999.
  
  
  RESULTS
  Rheumatic heart disease (91%) affecting the mitral valve, was the commonest indication for cardiac surgery (89%). Valve replacement with mechanical prostheses followed by anticoagulant therapy was carried out in 45%. There was no maternal death. Maternal morbidity from complications included pulmonary oedema (16%), cardiac arrythmias (4%), postpartum haemorrhage (3.5%). Other bleeding complications included epistaxis and haematoma at episiotomy site (2%). Impaired functioning of prosthesis (4%), severe pregnancy induced hypertension (2%) and thromboembolism (0.6%) were also observed. The abortion rate was 10.6%. There were 3 stillbirths (2%), another 6.7% babies were born preterm and 28% were lighter than appropriate for the period of gestation. There were no neonatal deaths. Coumarin derivatives were not associated with obvious foetal malformation.
  
  
  CONCLUSIONS
  With appropriate care, the outcome of pregnancy in women who have had cardiac surgery is favourable, if their functional class is good.
authors: Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Center, Karachi.
authors: S Z
authors: SZ
authors: Bhutta
authors: S
authors: S
authors: Aziz
authors: R
authors: R
authors: Korejo
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006331:Heart Diseases / Q000601:surgery; D006801:Humans; D008946:Mitral Valve Stenosis / Q000601:surgery*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D011256:Pregnancy Outcome; D011446:Prospective Studies