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

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.

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

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.

scholarly journals Impact and outcome of cardiac diseases in pregnancy

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.

scholarly journals Eclampsia at a tertiary care hospital of Nepal: A five year study

2018 ◽  
Vol 6 (2) ◽  
pp. 14-21
Author(s):  
Shraddha Rana ◽  
Pramod Kattel
Keyword(s):  
Blood Pressure ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Mortality ◽  
Care Hospital ◽  
Cross Sectional ◽  
National Medical

Background and Objectives: Eclampsia poses a global threat in terms of feto-maternal morbidity and mortality and all medical practitioners fear the ailment. It is one of the major causes behind preventable maternal death. Etio-pathogenesis of the disease condition is ambiguous and is considered to be multi-factorial. This study was done to analyze cases of eclampsia in relation to maternal and fetal outcomes at a tertiary level care hospital. Materials and Methods: A descriptive cross-sectional observational study was carried out in patients developing eclampsia over a period of five years starting from July 2011 to June 2016 at National Medical College and Teaching Hospital, Birgunj. Relevant data were collected from the statistics section of hospital reviewing the case sheets. Results: There were 291 cases of eclampsia out of 16,445 deliveries and prevalence of eclampsia was calculated to be 1.77%. Fourty-five percent of eclamptic women had age less than 20 years and two-third was primigravida. Approximately 84% of women were unbooked. Antepartum eclampsia was observed in 78.8% followed by postpartum eclampsia (14.8%) and intrapartum eclampsia (6.5%).  At the time of admission systolic blood pressure more than 140 mmHg and diastolic blood pressure more than 90 mmHg were noted in 79% and 92.1% cases respectively. Caesarean section was the preferred mode of delivery and was performed in 62.9% cases. ICU admission was required in 35.7% and remaining cases were managed in general/eclampsia ward. Renal failure was the most common cause of maternal mortality seen in 29.4%. Still birth was noted in 13.4%. Conclusion: Institutional obstetric patients are gradually facing eclampsia as prime cause of maternal death and unfortunately most of the cases are primigravid at younger age. All health care professionals should be proficient to manage eclamptic women instantaneously. Key words: Eclampsia; Fetal Mortality; Maternal Mortality; Pre-Eclampsia

scholarly journals Cardiac diseases in pregnancy leading to maternal mortality

2021 ◽  
Vol 8 (3) ◽  
pp. 359-363
Author(s):  
Sheetal A Ghugare ◽  
Lalita Y Patil ◽  
Kusum D Jashnani
Keyword(s):  
Heart Disease ◽  
Maternal Mortality ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Left Ventricular ◽  
High Morbidity ◽  
Cardiac Diseases ◽  
Care Hospital ◽  
Formalin Fixed Paraffin Embedded ◽  
In Pregnancy

1) To correlate age and gravida; 2) To correlate gross and histopathological findings of heart; 3) To evaluate postpartum complications and neonatal condition in maternal autopsies due to cardiac disease. This is 3 years retrospective study in a tertiary care hospital from 1 January 2015 to 31 December 2017. Total 1895 autopsies were performed by pathology department in these 3 years, out of which 158 (10.76%) maternal mortality autopsies were performed. Of which 17 (8.33%) maternal mortality autopsies due to cardiac diseases in pregnancy. The gross specimen of heart and formalin fixed paraffin embedded sections were stained with Haematoxylin and Eosin were reviewed for histopathological examination.35.29% maternal mortality occurred due to chronic rheumatic heart disease. 29.40% maternal mortality occurred due to dilated cardiomyopathy. 23.52% maternal mortality occurred due to ventricular failure. 11.76% maternal mortality occurred due to myocarditis. Most common age group involved was between 21-30 years, mainly seen in multigravida in 13 (76.47%) cases with postpartum complications. Most common presenting complaint was breathlessness in 17 (100%) followed fever with chills in 8 (52.94%) cases. Out of 17 cases, 14 (82.35%) cases delivered normal vaginally and 12 (70.58%) cases had live baby. On gross examination of heart, it was moderate to markedly enlarged due to ventricular dilation with marked hypertrophy of left ventricular wall. On microscopic examination, myocardial muscle fibre hypertrophy with disarray of myofibers, valvulitis, myocarditis and subendocardial fibrosis seen. Pregnancy in women with heart disease is associated with high morbidity & mortality rates. So they should receive appropriate antenatal counselling & care. Proper evaluation of maternal prognosis is required prior to conception in women with heart disease. So adequate clinical follow up during pregnancy is needed for proper outcome in these patients.

scholarly journals Study of maternal and perinatal outcome among twin pregnancies with one twin demise

2019 ◽  
Vol 8 (7) ◽  
pp. 2622
Author(s):  
Sunanda N. ◽  
Akhila M. V.
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Time Interval ◽  
Delivery Mode ◽  
Care Hospital ◽  
Monochorionic Twins ◽  
Medical College ◽  
Twin Pregnancies

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.

scholarly journals Comparative study of vaginal delivery and caesarean section in antepartum eclampsia at tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 457 ◽  
Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Fetal Outcome ◽  
Sudden Onset ◽  
Care Hospital ◽  
Maternal Complications

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.

scholarly journals Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Archana Kumari ◽  
Avinash Chakrawarty ◽  
Abha Singh ◽  
Ritu Singh
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neurological Involvement ◽  
First Episode ◽  
Care Hospital ◽  
Spot Urine ◽  
High Dependency ◽  
Developed World

Objective. To investigate association between maternofoetal complications and the amount of proteinuria measured by spot urine protein creatinine ratio in patients with preeclampsia.Methods. 200 consecutive patients with preeclampsia were recruited in the study. The complications like first episode of severe hypertension, renal insufficiency, raised level of aspartate transaminase, signs of neurological involvement, thrombocytopenia, eclampsia, and need to shift in intensive care units were studied. The maternal outcome was studied in terms of type of labour, outcome of pregnancy, mode of delivery, indication of cesarean section, and maternal mortality. The foetal complications and outcome parameters were birth weight, Apgar score at the time of birth and at five minutes, need of high dependency unit care, and perinatal mortality.Result. The frequency of various maternal and foetal complications was between 14–53% and 22–92%, respectively. Maternal mortality was 3%, whereas perinatal mortality was 23%. Statistically significant association was found between the frequencies of various complications in mother and newborn and spot UPCR.Conclusion. The rate of various maternofoetal complications in preeclampsia is higher in developing countries than in developed world. Maternofoetal complications and outcome correlate with maternal spot UPCR.

scholarly journals Feto-maternal outcome in pregnancy beyond 40 weeks

2017 ◽  
Vol 6 (2) ◽  
pp. 527 ◽  
Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
In Pregnancy

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.

scholarly journals Maternal outcomes of rheumatic heart disease in pregnancy

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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