MATERNOFETAL OUTCOME IN PATIENTS WITH CARDIAC DISEASES IN A TERTIARY CARE HOSPITAL

Abstract

Objective: The aim of this study was to determine the maternal and fetaloutcome in pregnant cardiac patients.

Methodology: This cross sectional study was carried out in Gynae B unit of LadyReading Hospital from January 2013 to 2016 . All cardiac patients with evidenceof cardiac problem on echocardiography, presenting to labour suit were included.Patients presenting for termination of pregnancy before 24 weeks of gestationwere excluded from the study. Complete cardiovascular and obstetricalexamination was carried out. NYHA class was determined at the time ofpresentation. Maternal and fetal outcomes like C-section, postpartumhaemorrhage, pulmonary oedema and maternal death, prematurity, still birth andlow birth weight were studied. Chi square test was applied for analyzing the data.

Result: A total of 98 pregnant ladies with cardiac diseases were included. Out of98 patients, 22% were newly diagnosed with cardiac disease while 78% werealready diagnosed cardiac patients at time of study. About 69% of the patientswere in the NYHA class I, II and 31% were in NYHA III, IV. Acquired heart lesionswere present in 81% patients and congenital heart defects in the remaining 19%cases. Mitral stenosis being the most common problem accounting for 51% ofcases. Peripartum cardiomyopathy was present in 12% of cases. Postpartumhaemorrhage occured in 22.4% of the patients,15.3% of the patients developedpulmonary oedema. The still birth frequency was 18%. Maternal death occured in4(4%)of the cases (p<0.01).

Conclusion: While some of the complications related to cardiac diseases inpregnant patients are unavoidable, proper pre and post pregnancy counselingcan make a huge difference.