Maternal and fetal outcome in valvular heart disease.
OBJECTIVE
To compare the pregnancy outcomes of women having valvular heart disease with the pregnancy outcomes of healthy women.


METHODS
A retrospective comparison of the maternal and fetal pregnancy outcomes of 312 women with valvular heart disease and 321 healthy women cared for at a tertiary care hospital during the same period. Statistical analysis was done using the chi(2)-test, with significance fixed at 0.05.


RESULTS
Women with valvular heart disease had a significantly higher incidence of surgical interventions during pregnancy than women in the control group [13.4% (balloon mitral valvotomy) vs. 0.6% (ovarian cystectomy)], congestive heart failure (5.1% vs. 0%, P<0.001), and mortality [0.64% (two women) vs. 0%]. Perinatal outcome was also more adverse in the valvular heart disease group than in the control group, with increased preterm delivery rate (48.3% vs. 20.5%), reduced birth weight (2434+/-599 g vs. 2653+/-542 g; P<0.001), and a higher incidence of APGAR scores less than 8 (8.3% vs. 4%; P<0.01). There was also a higher rate of instrumental delivery (9.9% vs. 3.4%). However, the rate of cesarean deliveries was similar in the two groups.


CONCLUSIONS
Pregnancy in women with valvular heart disease is associated with significantly higher maternal morbidity and adverse fetal outcomes and requires a team approach for optimal management.
Malhotra
M
M
Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India. monikachawla@hotmail.com
Sharma
J B
JB
Tripathii
R
R
Arora
P
P
Arora
R
R
D000740:Anemia / Q000453:epidemiology / Q000209:etiology; D001034:Apgar Score; D001724:Birth Weight; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D036861:Delivery, Obstetric; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000601:surgery; D006801:Humans; D009017:Morbidity; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality / Q000601:surgery; D011256:Pregnancy Outcome; D012189:Retrospective Studies