Evaluation and outcome of pregnancy complicated by heart disease.
OBJECTIVE
To assess the maternal and fetal outcome in pregnancies associated with maternal heart disease.


METHODS
The study included 50 pregnant cardiac patients from the Department of Obstetrics and Gynaecology Unit-I Nishtar Hospital, Multan. Age, parity, type of cardiac lesions, class of disease, specific treatment given, obstetric and cardiac complications, maternal and fetal outcome were analyzed.


RESULTS
Out of 5100 obstetric patients, 50 cases of heart disease were diagnosed, giving a frequency of 0.98%. The ages of the women ranged between 26-35 years (64%) and 52% were multigravida. Congenital Heart Disease (CHD) was present in 28% cases and 66% had Rheumatic Heart Disease (RHD) and mitral stenosis which was the dominant lesion. Anticoagulation was given to 3 (6%) cases, Digoxin was required in 20 (40%) cases, Diuretics 18 (36%) while antihypertensive and beta blockers were given to 4 (8%) cases each, whereas prophylactic antibiotic was given to all (100%) patients. Congestive Cardiac Failure (CCF) was seen in 10 (20%) cases, infective endocarditis and thromboembolism in one (2%) case each. Maternal mortality occurred in one (2%) case and one (2%) neonatal death was encountered. Cardiomyopathy was seen in 2 (4%) cases. Vaginal delivery was had in 91.49% women and 80% were term pregnancies. Preterm deliveries were 14% and 42.55% babies were of low birth weight.


CONCLUSIONS
Although, heart disease is rare among pregnant women, it needs to be carefully managed in a tertiary care setting by a team of obstetrician, cardiologist and anaesthesiologist, to obtain good maternal and foetal outcome.
Asghar
Farhana
F
Department of Obstetrics and Gynaecology, Unit I, Nishtar Hospital, Multan.
Kokab
Hina
H
D000328:Adult; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy* / Q000401:mortality; D011256:Pregnancy Outcome; D012307:Risk Factors; D015996:Survival Rate
D002317:Cardiovascular Agents