title: Heart disease in pregnancy: cardiac and obstetric outcomes.
abstract: BACKGROUND
  A retrospective analysis of the records of all the patients of heart disease with pregnancy at AIIMS, New Delhi, India, to find out the maternal and fetal outcome.
  
  
  METHODS
  A retrospective analysis was carried out of 100 pregnancies in women with heart disease who delivered at ≥28 weeks of gestation from July 2009 through August 2012.
  
  
  RESULTS
  Cardiac disease was found to complicate 3.8 % of pregnancies. Rheumatic heart disease (n = 64, 64 %) was the predominant cardiac disease. Congenital heart disease was found to complicate 36 pregnancies (n = 36, 36 %).Cardiac complications were seen in 32 (32 %) and fetal complications in 18 (18 %) pregnancies. Fewer cardiac and postpartum complications were present in NYHA class I/II patients compared to NYHA III/IV patients (P < 0.05). Pregnancy outcome was better in rheumatic heart disease patients who had undergone cardiac intervention prior to pregnancy (n = 29, 45.2 %) compared to those whose heart disease remained uncorrected (n = 35, 54.8 %) but the difference was not statistically significant. There was one maternal mortality in a patient with Eisenmenger syndrome. Two of the newborns of the 17 women who had received anticoagulants had features of warfarin embryopathy.
  
  
  CONCLUSIONS
  Pregnancy in women in NYHA class III/IV is associated with significantly higher maternal morbidity and cardiac interventions before pregnancy, when indicated may improve pregnancy outcome.
authors: Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India. muralidraiims@gmail.com
authors: Murali
authors: M
authors: Subbaiah
authors: Vaishali
authors: V
authors: Sharma
authors: Sunesh
authors: S
authors: Kumar
authors: S
authors: S
authors: Rajeshwari
authors: Shyam Sunder
authors: SS
authors: Kothari
authors: Kallol Kumar
authors: KK
authors: Roy
authors: Jai Bhagwan
authors: JB
authors: Sharma
authors: Neeta
authors: N
authors: Singh
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects; D001021:Aortic Valve; D001724:Birth Weight; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced; D005317:Fetal Growth Retardation / Q000209:etiology; D006330:Heart Defects, Congenital / Q000150:complications*; D006349:Heart Valve Diseases / Q000150:complications*; D006801:Humans; D008943:Mitral Valve; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy / Q000209:etiology; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000628:therapy; D012720:Severity of Illness Index; D014859:Warfarin / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin