Maternal mortality from heart disease in pregnancy.

Background: Heart diseases in pregnant women and has higher incidence of maternal mortality and morbidity and is regarded as risk factor for unfavourable outcome of pregnancy both for the mother and the foetus. Heart disease in pregnancy was found to be second indirect cause contributing to maternal mortality in India.Methods: This study is a hospital based prospective analytical study carried out in the Department of Obstetrics and Gynaecology, Sultania Zanana Hospital, Gandhi Medical College, Bhopal over a period of 1 year from 1st March 2017 to 28th February 2018. Patients were evaluated clinically by both obstetrician and cardiologist and followed all through their hospital stay till discharge.Results: Total 51 cases of heart disease were found during the study period. Incidence of heart disease in our study during study period was found 0.25%. Most patients were unbooked 33(64.71%) and maximum number of patients belonged to NYHA functional class II 24 (47.06%), RHD cases were 4 times more common than CHD. 24 (47.06%) patients had undergone surgical intervention for heart disease. Congestive cardiac failure was most common complication seen. Three maternal deaths were seen. All cases belonged to NYHA functional class III. All 3 cases were unbooked presented first time in labor.Conclusions: We found that pregnancy outcome was good in booked cases with regular checkup by obstetrician and cardiologist, surgically corrected cases and those with NYHA functional class I and II. Hence, joint management by obstetrician, cardiologist, and anesthetist is required to ensure better maternal outcome.

Download Full-text

A study to evaluate pregnancy with maternal heart disease: a prospective observational study at a tertiary care centre in India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211150 ◽

2021 ◽

Vol 10 (4) ◽

pp. 1637

Author(s):

Khushboo Goel ◽

Sanjaykumar G. Tambe

Keyword(s):

Heart Disease ◽

High Risk ◽

Observational Study ◽

Maternal Mortality ◽

Prospective Observational Study ◽

Neonatal Outcome ◽

Risk Group ◽

High Risk Group ◽

Heart Disease In Pregnancy ◽

In Pregnancy

Background: Prevalence of heart disease in pregnancy vary from 0.3-3.5%. Normal pregnancy is associated with physiological cardiovascular changes. These changes may unmask underlying cardiac disease in normal women and increase morbidity and mortality in women with heart disease. Heart disease in pregnancy is an important cause of maternal mortality in India. The aim of this study was to evaluate the maternal and neonatal outcome of pregnancy with heart disease.Methods: A prospective observational study was conducted at Sassoon General Hospital, Pune, India. 75 patients who fulfilled the inclusion criteria were studied. Maternal and neonatal outcome were analyzed.Results: Maternal heart disease was classified into congenital (36%) and acquired (64%). In acquired variety, rheumatic heart disease was most commonly seen. In congenital, ASD was most common. We divided the cases into two groups based on their NYHA status, low risk group had 74.67% patients and high risk group had 25.33% patients. The most common antenatal complication was PROM (41.3%). There was statistically significant association between ICU admission and high-risk group. The most common neonatal complications were IUGR and prematurity. Maternal mortality rate in the study group was 6.6%.Conclusions: The perinatal outcome of heart disease in pregnancy is more dependent on the severity of symptoms rather than the duration and type of heart disease. Multidisciplinary evaluation is necessary. Suboptimal optimization of the heart condition in the antenatal period and delayed referral were the major risk factor for maternal mortality.

Download Full-text

FETOMATERNAL OUTCOME OF PREGNANCY WITH HEART DISEASE IN A TERTIARY CARE HOSPITAL OF KOLKATA IN EASTERN INDIA

10.36106/ijsr/2503674 ◽

2021 ◽

pp. 21-23

Author(s):

Kajal Kumar Patra ◽

Dipnarayan Sarkar ◽

Sukhamoy Saha

Keyword(s):

Heart Disease ◽

Maternal Mortality ◽

Tertiary Care ◽

Mode Of Delivery ◽

Multiple Pregnancy ◽

Care Hospital ◽

Age Group ◽

Normal Delivery ◽

Heart Disease In Pregnancy ◽

In Pregnancy

BACKGROUND: Heart disease in pregnancy is still a major problem worldwide, particularly in low resource country like India. Its reported incidence varies between 0.1 to 4%. Heart disease complicates 1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. In India, the rheumatic heart disease (RHD) contributes to approximately 70% of heart disease seen in pregnancy. Heart disease in pregnancy is associated with adverse fetomaternal outcome and has re-emerged as one of the leading causes of maternal mortality. The maternal mortality rate in women with cardiac disease is 7% and morbidity is 30% during pregnancy in India. METHODS: This study was a prospective observational study conducted in the IPGMER & SSKM Hospital, Kolkata, West Bengal from December 2020 to February 2021. 36 Pregnant women with heart disease were taken as study group. Multiple pregnancy and any other medical disorder like GDM, PIH, were excluded from study. Fetomaternal outcome, mode of delivery, prematurity, LBW, NICU admission and maternal and neonatal mortality were compared. Template was generated in MS excel sheet and analysis was done on SPSS software. RESULTS: Among 36 patients 14 (38.89%) patients belonged to age group 25-29 years and 2 (5.56) belonged to age group <20 years. 13 (36.11%) patients belonged to lower middle class and 17 (47.22%) belong to lower class. 19 (52.78%) patients were P and 9 (25%) were P parity group. 20 (55.56%) belong to gravida G1. 10 (27.78%) 0+0 1+0 patients had CHD and RHD. 20 (55.56%) were normal delivery. 13 (36.11%) of babies were underweight. Maternal death were 2 (5.56%). CONCLUSIONS: Feto-maternal outcome can be improved appreciably by antenatal care, early diagnosis and management.

Download Full-text

Fetomaternal outcome in women with heart disease in urban population in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183777 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3684

Author(s):

Preeti Sharma ◽

Renuka Malik

Keyword(s):

Heart Disease ◽

Maternal Mortality ◽

Tertiary Care ◽

Mode Of Delivery ◽

Multiple Pregnancy ◽

Fetal Mortality ◽

Delivery Mode ◽

Care Hospital ◽

Heart Disease In Pregnancy ◽

In Pregnancy

Background: Heart disease in pregnancy is still a major problem worldwide, particularly in low resource country like India. Its reported incidence varies between 0.1 to 4%. Heart disease complicates 1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. In India, the rheumatic heart disease (RHD) contributes to approximately 70% of heart disease seen in pregnancy. Heart disease in pregnancy is associated with adverse fetomaternal outcome and has re-emerged as one of the leading causes of maternal mortality. The maternal mortality rate in women with cardiac disease is 7% and morbidity is 30% during pregnancy in India.Methods: This study was a prospective observational study conducted in the department of obstetrics and gynaecology at PGIMER & Dr. RML hospital from Nov 2015 to March 2017. 35 Pregnant women with heart disease were taken as study group and 35 low risk pregnant patients were taken as control. Multiple pregnancy and any other medical disorder like GDM, PIH, IHCP and thyroid disorders were excluded from study. Fetomaternal outcome in terms of POG at delivery, mode of delivery, prematurity, LBW, NICU admission and maternal and neonatal mortality were compared between these two groups.Results: Vaginal delivery is still the common mode of delivery. Preterm delivery, prematurity, ICU admission, low birth weight is more common in pregnancy with heart disease than in normal pregnancy.Conclusions: Although maternal mortality and fetal mortality is reduced, pregnancy with heart disease still carries substantial risk to mother and child.

Download Full-text

A RETROSPECTIVE STUDY ON CARDIAC DISEASE IN PREGNANCY

10.36106/paripex/2100520 ◽

2021 ◽

pp. 15-19

Author(s):

Mounika Edupuganti ◽

Panthagani Vineela

Keyword(s):

Heart Disease ◽

Maternal Mortality ◽

Cardiac Disease ◽

Developed Countries ◽

African Countries ◽

Common Etiology ◽

The Common ◽

Heart Disease In Pregnancy ◽

Rheumatic Heart ◽

In Pregnancy

Cardiac disease in pregnancy is one of the common ,indirect obstetric causes of maternal mortality reported incidence varying between 0.5 and 5.9% worldwide. The rise in maternal mortality has been attributed to increasing numbers of women at advanced maternal age undertaking pregnancy, comorbid pre-existing conditions such as diabetes mellitus and hypertension and the growing number of women with congenital heart disease surviving to childbearing. Valvular heart disease is present in 80% of patients with heart disease during pregnancy in developing countries with rheumatic fever as the most common etiology and the mitral valve being the most commonly affected valve, but is uncommon in developed countries. Heart failure complicating rheumatic heart disease in pregnancy has been described in 22% women presenting to clinics in India and few African countries.

Download Full-text

Maternal mortality risk factor in pregnancy with heart disease at Dr. Soetomo General Hospital, Surabaya, Indonesia

Majalah Obstetri & Ginekologi ◽

10.20473/mog.v1i12019.17-23 ◽

2019 ◽

Vol 27 (1) ◽

pp. 17

Author(s):

Laili Muninggar ◽

M Yusuf ◽

Budi Prasetyo

Keyword(s):

Heart Disease ◽

Maternal Mortality ◽

Maternal Death ◽

Mortality Risk ◽

Functional Class ◽

Antenatal Visit ◽

Cross Sectional ◽

Cross Sectional Design ◽

Heart Disease In Pregnancy ◽

In Pregnancy

Objectives: This research want to identify some factors that increasing risk of maternal death in pregnant woman with heart disease.Materials and Methods: This study was a retrospective analytic study with cross sectional design, with total sampling 92 patient with heart disease in pregnancy at maternity room Dr. Soetomo hospital, Surabaya, during periode January until December 2017.Results: Prevalency of pregnancy with heart disease in dr. Soetomo hospital about 0,5% with mortality that caused by heart disease 14% from all maternal death. Factors that increase risk of maternal death are non adequate antenatal visit number (OR 1,7;CI 95%), delay of detecting heart disease (OR 2,5;CI 95%), complication such as severe pulmonal hypertension (OR 61,4;CI 95%), Eisenmenger syndrome (OR 2,9;CI 95%), Decompensatio Cordis Functional Class IV (OR 1,2;CI 95%), and Thrombo-embolism (OR 9;CI 95%).Conclusion: Mortality rate in pregnancy with heart disease is 14% of all maternal mortality. Risk of maternal death increased by non adequate antenatal visit and delay in heart disease detection, and also medical complications. Detection of heart disease since before pregnant with pre-conceptional councelling and a good managed multidisciplinary antenatal care supposed to decrease morbidity and mortality.

Download Full-text