785: Planned mode of delivery and maternal morbidity in women with cardiac disease in pregnancy

Background: Heart disease complicating pregnancy is an important indirect cause of maternal mortality and morbidity. Maternal heart disease comprises .2%-2% of pregnancies and responsible for 10%-20% of maternal deaths1. Our study was done to evaluate fetomaternal outcomes in pregnancy with heart disease.Objectives: Evaluation of fetomaternal outcome in pregnant patients with cardiac disease. Materials andMethods: This observational study was done in Bangabandhu Sheikh Mujib Medical University and Anwer Khan Modern Medical College Hospital among 51 pregnant women with known or newly diagnosed heart disease from January 2013-january 2015. Baseline data recorded demographic character, NYHA functional class, maternal complications, mode of delivery and neonatal outcome.Results: Among 51 cardiac patients, 32 (63%) were primigravida. Mostly 46 (90.6%) belonging to NYHA Class I and II. Rheumatic heart disease seen in 45 (87%) and congenital heart disease in 10% subjects. Mitral stenosis was the most common, seen in 22 (41%) cases. 47.33% patients were delivered vaginally and LSCS done in 41% patients. The fetal outcome were live births in (96.6%) cases, (27.4%) babies required NICU admission.Conclusion: An improvement in modern techniques of monitoring, better understanding of pathophysiology of cardiac disease and multi disciplinary care can lead to substantial improvement in the feto maternal outcome.Anwer Khan Modern Medical College Journal Vol. 8, No. 2: Jul 2017, P 112-116

Download Full-text

Impact and outcome of cardiac diseases in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205432 ◽

2020 ◽

Vol 10 (1) ◽

pp. 102

Author(s):

Gira Dabhi ◽

Jignesh Chauhan ◽

Munjal Pandya ◽

Rahul Sinhar

Keyword(s):

Heart Disease ◽

Cardiac Disease ◽

Nyha Class ◽

Demographic Data ◽

Tertiary Care ◽

Mode Of Delivery ◽

Close Monitoring ◽

Care Hospital ◽

Tertiary Care Centre ◽

In Pregnancy

Background: Present study done to study incidence, effect of pregnancy on cardiac disease and vice-versa and feto-maternal outcome in patients with cardiac disease in pregnancy at tertiary care hospital.Methods: It’s a retrospective observational study conducted in Department of OBGY at tertiary care hospital between 01 June 2019 to 31 May 2020. 28 cases of cardiac disease out of 8659 patients registered included in the study. Demographic data like age, parity, etiological factors of cardiac disease, mode of delivery, neonatal outcome noted from case records.Results: In study, 32% were unregistered cases and 10.7% had never sought any medical care before. Majority (53.6%) cases belonged to 20-25 years. Heart disease noted to be more in primipara (35.7%). 71.4% belonged to NYHA class 1+2 and had a relatively uneventful peripartum period. Majority (53.6%) patients had rheumatic valvular disease. Cases of Congenital heart disease were17.8%, pulmonary artery hypertension was 25%, Maternal mortality were 2(7.2%). 46.5% women delivered with caesarean section. PIH (18%) and anemia (7.2%) were most commonly associated conditions. 85.6% women delivered live newborns and full term, pre-term deliveries and IUGR were 71.4%, 17.8% and 10.7% respectively.Conclusions: Rheumatic origin is the most common cardiac disease associated with pregnancy. The availability of early diagnostic techniques and reference to tertiary care centre, timely admission and close monitoring of patient and delivery with multidisciplinary approach include specialized cardiologic care, high risk obstetric support and neonatology expertise can minimize feto-maternal morbidity and mortality. Pre-conceptional counselling, regular antenatal check-ups and contraceptive advice must be included in counselling part.

Download Full-text

MATERNALAND FETAL OUTCOME IN PREGNANCY WITH HEART DISEASES

10.36106/ijsr/9701670 ◽

2021 ◽

pp. 46-47

Author(s):

Sweety Sinha

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Cardiac Disease ◽

Congenital Heart ◽

Heart Diseases ◽

Mode Of Delivery ◽

Fetal Outcome ◽

College Hospital ◽

Mortality And Morbidity ◽

In Pregnancy

Background: Cardiac disease is an important cause of maternal mortality and morbidity both in antepartum and postpartum period. The overall incidence of heart disease in pregnancy is <1%. Objective of present study was to determine maternal outcome in pregnant women with heart diseases in terms of fetal complication, maternal complication and Mode of delivery. Methods: This study was conducted in the Department of Obstetrics and Gynaecology at PATNA MEDICAL COLLEGE,HOSPITAL,patna. 40 women with heart disease which were previously established or diagnosed during pregnancy were enrolled in the study. Results:In 40 women pregnancies was complicated by heart disease in the study. The prevalence of heart disease amongst all pregnancies found in hospital was 4.3%. The principal cause of cardiac lesion was Rheumatic heart disease (RHD) (62.5%) while congenital heart disease was seen in 12.5%. Among the women who had RHD, mitral stenosis seen in 15 (37.5%) was most common lesion and Multiple cardiac lesions 10 (25%) women. Among the women with congenital cardiac disease, mitral valve prolapse was most common constituting 5 (12.5%) cases. women delivered by caesarean section were14(35%) while 26(65%) had vaginal delivery. with spontaneous onset of labour in 20(50 %)and assisted instrumental vaginal delivered in 6 patients. There was 1 maternal death. No baby had congenital heart disease. 70% babies born weighed more than 2kg. Conclusions:This study concluded that pre- pregnancy diagnosis, counselling, appropriate referral, antenatal supervision and delivery at equipped centre improve the pregnancy with heart disease outcome for both mother and baby

Download Full-text

734 Severe maternal morbidity by modified WHO classification in women with cardiac disease in pregnancy

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.757 ◽

2021 ◽

Vol 224 (2) ◽

pp. S460-S461

Author(s):

Anna DeNoble ◽

Jerome Federspiel ◽

Lauren Wein ◽

Sarah Goldstein ◽

Chad Grotegut

Keyword(s):

Cardiac Disease ◽

Maternal Morbidity ◽

Who Classification ◽

Severe Maternal Morbidity ◽

In Pregnancy

Download Full-text

Fetomaternal outcomes in pregnancy with different cardiac disease at a tertiary care center in Udaipur

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204003 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3983

Author(s):

Keerti Chaudhary ◽

Sangeeta Sen

Keyword(s):

Heart Disease ◽

Pregnant Women ◽

Gestational Age ◽

Cardiac Disease ◽

Systolic Function ◽

Tertiary Care ◽

Mode Of Delivery ◽

Cardiac Complications ◽

Cardiac Diseases ◽

In Pregnancy

Background: The incidence of maternal cardiac diseases has an adverse effect on pregnancy outcomes. The present study was done the objective to determine the Incidence and distribution of cardiac disease in pregnant patients, to assess mode of delivery and fetomaternal outcome in pregnancy with heart disease patients.Methods: This was a hospital based prospective observational study that include 65 pregnant women with diagnosed cardiac disease or had symptoms and signs suggestive of cardiac disease during the period from January 2018 to December 2019. Baseline data recorded including age, parity, gestational age, cardiac lesions, New York heart association (NYHA) functional class, use of cardiac medications, thorough clinical examination including chest and cardiovascular auscultation, ECG and echocardiographic assessment of left and right ventricular systolic function. Fetomaternal outcome was analysed in the study.Results: The mean age of the patients was 24.33±2.93 years (ranging from 19-36 years). 34 patients (52.30%) were primigravida. Majority (58.46%) cases were from rural area. Majority patients (70.77%) are present between 37-40 weeks of gestational age. Most of patients had vaginal delivery (64.62%). 43 patients (66.15%) diagnosed with heart disease after pregnancy, while 22 patients (33.85%) are diagnosed before pregnancy for heart disease. Neonatal complications were seen in in 35.38% of patients. Cardiac complications were present in 40% of patients. majority of fetal complications are in nonoperated patients (46.15%).Conclusion: The management of pregnant women with cardiac diseases requires multidisciplinary approach to prevent morbidity and mortality. It is necessary to optimize healthcare facilities to obtain maximum maternal and fetal outcome.

Download Full-text

FETOMATERNAL OUTCOME IN PREGNANCY WITH CARDIAC DISEASE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i7.2007 ◽

2021 ◽

Vol 5 (7) ◽

Author(s):

Kalyani K Bafna ◽

Kanaklata Nakum ◽

Aditi Vithal

Keyword(s):

Heart Disease ◽

Pregnant Women ◽

Cardiac Disease ◽

Maternal Morbidity ◽

Nyha Class ◽

Mode Of Delivery ◽

Fetal Outcome ◽

Morbidity And Mortality ◽

Maternal Complications ◽

Maternal Morbidity And Mortality

Objective(S): Cardiac disease is an important cause of maternal morbidity and mortality in both antepartum as well as in postpartum period. Incidence of heart disease with pregnancy is <1%. Aim of this study is to determine maternal complications with heart disease, mode of delivery & fetal complications. Materials & Methodology: This is a retrospective study conducted at Gopinath Maternity Home, Sir-T Hospital, Bhavnagar. From May 2020- April 2021. All pregnant women with various cardiac disease (previously established or diagnosed during pregnancy) who came to labor room or OPD are included. Result: 30 pregnant women out of 2683 deliveries were identified with cardiac disease giving prevalence of 1.12% in this study. 15(50%) women belonging to NYHA class-1 & 8(26.6%) belonged to NYHA class 2. Class 3(3 patients =10%) & class 4(4patients= 13.3%) were admitted immediately. 18(60%) women were case of valvular heart disease, out of which 12(66.6%) cases were of RHD, 2(11.1%) were MS, 3(16.6%) AS, 1(5.5%) MR. 10(33.33%) cases were congenital heart disease. Maternal mortality were 4(13.33%). Out of 30 cases, 18(69.2%) women had LSCS, 6(23.07%) had vaginal delivery,2(7.7%) had vaccum & 3(10.3%) had abortion. Out of 26 deliveries 2(7.7%) were IUFD, 6(23.07%) Preterm, 7(26.9%) IUGR. Total there were 9(37.5%) NICU admissions. Conclusion: Prognosis of pregnancy with heart disease has improved but management of it is still a challenge for obstetricians. Pre-conceptional counseling plays an important role by benefiting women with severe heart disease and thus help in reducing maternal morbidity and mortality. Keywords: cardiac disease, maternal outcome, fetal outcome

Download Full-text

A 25-Year-Old Pregnant Lady with Heart Disease

Journal of Enam Medical College ◽

10.3329/jemc.v7i1.30751 ◽

2017 ◽

Vol 7 (1) ◽

pp. 42-43

Author(s):

Jamila Khatun

Keyword(s):

Heart Disease ◽

Cardiac Disease ◽

Maternal Morbidity ◽

Congenital Heart ◽

Combined Treatment ◽

Healthy Baby ◽

Maternal Morbidity And Mortality ◽

Grade Ii ◽

Rheumatic Heart ◽

In Pregnancy

Cardiac disease in pregnancy is an important cause of maternal morbidity and mortality. Rheumatic heart disease and congenital heart disease are the commonest cardiac problems in our country. Here we report a 25-year-old lady who presented with 36 weeks of pregnancy with severe mitral stenosis with grade II mitral regurgitation and pulmonary hypertension. With combined treatment of cardiologist and obstetrician the patient delivered a healthy baby without any complication. She was discharged on 7th postnatal day with satisfactory condition.J Enam Med Col 2017; 7(1): 42-43

Download Full-text