Maternal and Foetal Outcome in Pregnancy with Heart Disease Admitted in Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar

BACKGROUND Heart disease complicating pregnancy is considered as a high-risk condition. Increased cardiac demands during the course of pregnancy potentially increase morbidity and mortality in women with underlying heart disease. Fifty percent increase in volume of plasma and increase in the risk of thrombosis by 6 times strikes a challenge to pregnant woman with heart disease. Pregnancy state is more prone to risk of infection as it is an immunocompromised condition which can result in increased heart rate eventually deteriorating the cardiac function. We wanted to determine maternal and foetal outcome in pregnant women with heart diseases in terms of foetal complications, maternal complications, and mode of delivery. METHODS A prospective clinical study conducted in Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar for delivery was carried to find out the maternal and foetal outcomes in about 30 cases of pregnancy complicated heart disease. Taking prevalence to be 4 % (P) with confidence interval of 95 % (Z = 1.96) and allowable error (d) 7 %, sample size was calculated using formula 𝑍 2𝑃𝑄/𝑑2 RESULTS Present study revealed heart disease in pregnancy as about 0.48 %. Rheumatic heart lesions constituted 56.6 % of the cases. Eleven (36.7 %) women delivered spontaneously vaginally at term. Caesarean section was performed in 12 cases (41.2 %). There were 2 maternal deaths. No perinatal deaths were reported. CONCLUSIONS Pregnancy and cardiac lesions affect mutually. Compliance of patient and her family to regular follow up will ensure a safe outcome for mother and foetus and avoid complications by regular checkups with obstetrician and cardiologist. KEY WORDS Cardiomyopathy, Pregnancy, Rheumatic Heart Disease, Maternal Morbidity, Maternal Mortality

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Study of Maternal and Fetal Outcome in Pregnancy with Heart Disease

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v8i2.33666 ◽

2017 ◽

Vol 8 (2) ◽

pp. 112-116 ◽

Cited By ~ 2

Author(s):

Sharmin Abbasi ◽

Sehereen Farhad Siddiqua ◽

Shifin Rijvi ◽

Salma Akhtar ◽

Benozir Haque ◽

...

Keyword(s):

Heart Disease ◽

Cardiac Disease ◽

Nyha Class ◽

Mode Of Delivery ◽

Fetal Outcome ◽

Functional Class ◽

Maternal Complications ◽

College Hospital ◽

Medical College ◽

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

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Maternal outcomes of rheumatic heart disease in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170512 ◽

2017 ◽

Vol 6 (3) ◽

pp. 802

Author(s):

Hema Priya L. ◽

Ambarish Bhandiwad ◽

Nagaraj Desai ◽

Triveni Kondareddy

Keyword(s):

Heart Disease ◽

Birth Weight ◽

Functional Status ◽

Rheumatic Heart Disease ◽

Cardiac Disease ◽

Heart Diseases ◽

Tertiary Care ◽

Heart Disease In Pregnancy ◽

Rheumatic Heart ◽

In Pregnancy

Background: Preexisting cardiac disease is seen in 1-3% of pregnancies. In developing countries, sequelae of rheumatic fever often constitute the majority of women with heart disease; whereas in developed countries, it is the congenital heart diseases. The aim of this study was to examine the changing trends and mode of care of women with Rheumatic heart disease in pregnancy over a period of five years in a tertiary care centre.Methods: Patient records over five years were retrieved and maternal and perinatal outcomes were documented. The present study reports the outcomes of 72 women with rheumatic heart disease.Results: The prevalence of heart disease in pregnancy in our study was 1.72%. The prevalence was higher among the rural population, and in lower socio economic strata. 30% of patients were diagnosed during pregnancy. The risk of complications co - related with their functional status at the onset of pregnancy. The mode of termination of pregnancy and indications for LSCS did not vary. However, the risk of complications was greatest during labour and post-partum period. The mean birth weight was 2.7 kg, however, 30% of term neonates were of low birth weight (<2.5 kg).Conclusions: Rheumatic heart disease continues to be a major cause of cardiac disease complicating pregnancy. However, early diagnosis, appropriate management prior to pregnancy, and good functional status at the time of entering pregnancy allowed for a good maternal and neonatal outcome.

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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

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Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal

10.37179/rijccm.000004 ◽

2020 ◽

Vol 01 (01) ◽

pp. 009-012

Author(s):

Laudari S

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Rheumatic Heart Disease ◽

Cross Sectional Study ◽

Secondary Prophylaxis ◽

Medical Sciences ◽

Cross Sectional ◽

Governmental Organizations ◽

Non Governmental Organizations ◽

Rheumatic Heart

Background and Aims: Secondary prophylaxis has remained the mainstay of rheumatic fever and rheumatic heart disease management. Despite the proven ef􀏐icacy and superiority of injectable penicillin in rheumatic heart disease patients, it has been underused in Nepal. Materials and Methods: This is a hospital based cross-sectional study during June 2014 to October 2018 over a period of 52 months at College of Medical Sciences-Bharatpur including 350 patients with clinical and/or echocardiographic evidence of de􀏐inite rheumatic heart disease. Data was collected from both cardiology outpatients and inpatients (admitted in cardioward/coronary care unit). Relevant data and information were entered into the pre-structured proforma and then analyzed by SPSS-16 software. Results: The age of the patients ranged from 6 to 80 years with mean age 36.76±4.6years with female preponderance (F:M=1.26:1). The predominantly involved isolated valve was mitral in 152 patients (44.43%) followed by aortic valve in 70 patients (20.00%) and rest 90 (25.71%) had dual valvular involvement. The common complications encountered were heart failure in 200(57.14%) and arrhythmias in 155(44.29%) patients. Two hundred ten (60.00%) of the patients received penicillin (oral and injectable) and erythromycin. Majority 180/210=85.71%) were prescribed on oral penicillin whereas only 46/210=21.90% received injectable penicillin; the ratio being 3.35:1. Conclusion: RHD is a leading cause of heart failure and death among young population. There is underuse of penicillin with very minimal focus on use of injectable penicillins currently. Hence, Nepal government and other non-governmental organizations should consider implementation of use of penicillin broadly and moreover focus on use and adherence of injectable penicillin. Keywords: Rheumatic Heart Disease, Penicillin, Underuse, Secondary Prophylaxis.

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AN EPIDEMIOLOGICAL ANALYSIS OF SOCIOECONOMIC RISK FACTORS AMONG PATIENTS OF RHEUMATIC HEART DISEASE, ISLAMABAD, PAKISTAN

Pakistan Journal of Public Health ◽

10.32413/pjph.v6i4.13 ◽

1970 ◽

Vol 6 (4) ◽

pp. 41-43 ◽

Cited By ~ 1

Author(s):

Zafar Hayat Maken ◽

Faizan Ahmed ◽

Ferogh E- Elahi ◽

Ali Arumghan ◽

Mehar . ◽

...

Keyword(s):

Risk Factors ◽

Heart Disease ◽

Rheumatic Heart Disease ◽

Economic Status ◽

Sampling Technique ◽

Medical Sciences ◽

Cross Sectional ◽

Male Predominance ◽

Significant Burden ◽

Rheumatic Heart

BACKGROUND: Rheumatic Heart Disease (RHD) is a disease of developing countries where it inflects significant burden dis-proportionality. We investigated the role of socio-economic and environmental risk factors for RHD. METHODS:Â· This was descriptive cross-sectional conducted at Pakistan Institute of Medical Sciences Islamabad by including the patients coming to cardiology out door patient department through convenient sampling technique. Study was approved from ethical committee of Pakistan institute of Medical Sciences Islamabad and written consent was taken prior to start the interview. RESULTS: In this study, the average age of patient with rheumatic heart disease was 29.4 years, male predominance of patients was observed. 67% of subjects had income below Rs. 20,000. Average BMI of subjects was 22.4Â±4.04. It was observed that 75.25 % of people lived in houses with an area of less than 5 marla. Average area of house was found to be 5.12Â±2.8 marla. Overcrowding was noticed in 60.8 % of the subjects. CONCLUSION: There is a high prevalence of RHD and Acute Rheumatic Fever (ARF) in Pakistan. The major findings of this study were that Overcrowding, poor hygienic conditions, low socio-economic status, are major risk factors for RHD. In order to address this alarming situation, platforms like Pakistan Pediatric Cardiac Society and Pakistan Pediatric Association need to be mobilized for health promotion regarding awareness of the disease.

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Maternal and fetal outcomes in rheumatic heart disease in pregnancy

International Journal of Research in Medical Sciences ◽

10.5455/2320-6012.ijrms20141172 ◽

2014 ◽

Vol 2 (4) ◽

pp. 1632

Author(s):

Dhivya Sethuraman ◽

Nirmala Ramachandran ◽

SAP Noorjahan ◽

Vijay Kanna

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

Fetal Outcomes ◽

Heart Disease In Pregnancy ◽

Rheumatic Heart ◽

In Pregnancy

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Rheumatic heart disease in pregnancy: How can health services adapt to the needs of Indigenous women? A qualitative study

Australian and New Zealand Journal of Obstetrics and Gynaecology ◽

10.1111/ajo.12744 ◽

2017 ◽

Vol 58 (4) ◽

pp. 425-431 ◽

Cited By ~ 9

Author(s):

Suzanne Belton ◽

Sue Kruske ◽

Lisa Jackson Pulver ◽

Juanita Sherwood ◽

Kylie Tune ◽

...

Keyword(s):

Heart Disease ◽

Qualitative Study ◽

Health Services ◽

Rheumatic Heart Disease ◽

Indigenous Women ◽

Heart Disease In Pregnancy ◽

Rheumatic Heart ◽

In Pregnancy

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Evaluation of Foetal Outcome in Pregnancy with Heart Disease in Tertiary Center in South Gujarat

Indian Journal of Obstetrics and Gynecology ◽

10.21088/ijog.2321.1636.6318.6 ◽

2018 ◽

Vol 6 (3) ◽

pp. 237-239

Author(s):

Manali Kapadia ◽

◽

Radhika Mohan ◽

Saral Bhatia ◽

Nilam Prajapati ◽

...

Keyword(s):

Heart Disease ◽

Tertiary Center ◽

Foetal Outcome ◽

In Pregnancy

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Validation of a simplified score for predicting latent rheumatic heart disease progression using a prospective cohort of Brazilian schoolchildren

BMJ Open ◽

10.1136/bmjopen-2020-036827 ◽

2020 ◽

Vol 10 (5) ◽

pp. e036827 ◽

Cited By ~ 1

Author(s):

Bárbara Martins Bechtlufft ◽

Bruno Ramos Nascimento ◽

Craig Sable ◽

Clara Leal Fraga ◽

Márcia Melo Barbosa ◽

...

Keyword(s):

Heart Disease ◽

Public Schools ◽

Rheumatic Heart Disease ◽

Heart Diseases ◽

Diagnostic Category ◽

Secondary Outcome ◽

Unfavourable Outcome ◽

History Of ◽

Rheumatic Heart

ObjectivesEchocardiographic (echo) screening is an important tool to estimate rheumatic heart disease (RHD) prevalence, but the natural history of screen-detected RHD remains unclear. The PROVAR+ (Programa de RastreamentO da VAlvopatia Reumática) study, which uses non-experts, telemedicine and portable echo, pioneered RHD screening in Brazil. We aimed to assess the mid-term evolution of Brazilian schoolchildren (5–18 years) with echocardiography-detected subclinical RHD and to assess the performance of a simplified score consisting of five components of the World Heart Federation criteria, as a predictor of unfavourable echo outcomes.SettingPublic schools of underserved areas and private schools in Minas Gerais, southeast Brazil.ParticipantsA total of 197 patients (170 borderline and 27 definite RHD) with follow-up of 29±9 months were included. Median age was 14 (12–16) years, and 130 (66%) were woman. Only four patients in the definite group were regularly receiving penicillin.Primary and secondary outcome measuresUnfavourable outcome was based on the 2-year follow-up echo, defined as worsening diagnostic category, remaining with mild definite RHD or development/worsening of valve regurgitation/stenosis.ResultsAmong patients with borderline RHD, 29 (17.1%) progressed to definite, 49 (28.8%) remained stable, 86 (50.6%) regressed to normal and 6 (3.5%) were reclassified as other heart diseases. Among those with definite RHD, 13 (48.1%) remained in the category, while 5 (18.5%) regressed to borderline, 5 (18.5%) regressed to normal and 4 (14.8%) were reclassified as other heart diseases. The simplified echo score was a significant predictor of RHD unfavourable outcome (HR 1.197, 95% CI 1.098 to 1.305, p<0.001).ConclusionThe simple risk score provided an accurate prediction of RHD status at 2-year follow-up, showing a good performance in Brazilian schoolchildren, with a potential value for risk stratification and monitoring of echocardiography-detected RHD.

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