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

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. 

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 Cardiac diseases in pregnancy: clinical profile and feto-maternal complications

2017 ◽  
Vol 6 (11) ◽  
pp. 4934
Author(s):  
Latika R. Mehta ◽  
Jagruti Shah
Keyword(s):  
Heart Disease ◽  
Cardiac Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Team Approach ◽  
Cardiac Diseases ◽  
Tertiary Care Center ◽  
Maternal Complications ◽  
Fetal Complications ◽  
In Pregnancy

Background: Pregnancy in woman with heart disease increases the risk of maternal and fetal complications. About 1% of pregnant women have concomitant cardiac disease. The present research was conducted to study the profile of cardiac diseases in pregnancy and its associated complications.Methods: A prospective analysis was carried out of 55 pregnancies of women with cardiac disease from at a tertiary care center. Standard Ante-natal care was furnished to all patients subjective to their requirements. Condition of patient during labour as well as the progress of labour was closely monitored. Fetal and maternal outcome after delivery as well as development of any complication was noted and treated accordingly. Data was analyzed using SPSS software ver. 21.0.Results: In present study, RHD constituted 71% cases while CHD constitutes 11% of all cases of heart disease. Other etiologies were dilated cardiomyopathies (DCM) (12.7%), IHD (3.6%) and arrhythmias (18%). Most common anomaly associated with RHD cases was mitral stenosis (75%) either isolated or along with other valvular pathologies. Most common CHD was atrial septal defect seen in 4 out of 6 cases. A total of 8 patients (16%) developed complications of which, 4 had postpartum hemorrhage, 2 developed pulmonary oedema, 1 had arrhythmia and 1 patient developed septic shock and multi organ failure. A total of 74% babies were healthy while IUGR and intrauterine deaths were seen in 22% cases and 4% cases respectively.Conclusions: Rheumatic heart disease is the predominant type of cardiac disease in pregnancy. Maternal and perinatal outcome can be improved by team approach at tertiary care center. Counselling for contraception and family planning and follow up during subsequent pregnancies is mandatory.

scholarly journals A study of maternal and fetal outcome in cardiac disease in pregnancy at tertiary care center

2017 ◽  
Vol 6 (11) ◽  
pp. 5095
Author(s):  
Kurra Sai Pujitha ◽  
Sheela S. R. ◽  
Naga Jyothi S.
Keyword(s):  
Heart Disease ◽  
Cardiac Disease ◽  
Perinatal Death ◽  
Care Center ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Cardiac Complications ◽  
Mitral Valve Stenosis ◽  
Tertiary Care Centre ◽  
In Pregnancy

Background: Cardiac disease complicating pregnancy is an indirect cause of maternal mortality. The incidence of cardiac disease during pregnancy has remained stable for many years even with significant decrease in the occurrence of rheumatic heart disease (RHD) as this decrease is being compensated by significant increase of pregnancy in women with congenital heart disease (CHD). Therefore, in this study we aim to analyse the incidence of cardiac disease in pregnancy and to assess the obstetrical outcome.Methods: A retrospective study carried out in 32 women with cardiac disorders at a tertiary care centre during the period of 5 years.Results: In the present study the incidence of cardiac disease in pregnancy was observed to be 0.21%. With 62.6% rheumatic, 21.8% congenital being and 15.6% peripartum cardiomyopathy. Among rheumatic valvular heart disease, mitral valve stenosis was most common followed by mitral regurgitation and tricuspid regurgitation. Non-cardiac complications like pre-eclampsia and anaemia were also noted. No of vaginal delivery were higher compared to caesarean (26 versus 6). Adverse perinatal outcomes in form of preterm, NICU admission and perinatal death were also noted.Conclusions: A cardiac disease has a major impact on pregnancy. It is a multidisciplinary teamwork to have optimal maternal and foetal outcome in women with cardiac disease. Hence, constant vigilance is required throughout antenatal, intrapartum and postpartum period to avoid adverse outcomes.

scholarly journals Characteristics shifting of heart disease in pregnancy: A report from low middle-income country

2021 ◽  
Author(s):  
Cyntia Puspa Pitaloka ◽  
Absa Secka ◽  
Ernawati Ernawati ◽  
Agus Sulistyono ◽  
Hermanto Tri Juwono ◽  
...  
Keyword(s):  
Developing Countries ◽  
Heart Disease ◽  
Pregnant Women ◽  
Cardiac Disease ◽  
Cardiac Complications ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Acquired Heart Disease ◽  
Heart Disease In Pregnancy ◽  
In Pregnancy

Background: Heart disease in pregnancy is one of the leading causes of maternal mortality and morbidity in developing countries. However, the characteristics of the disease vary between countries and regions. This study aimed to present the characteristics of pregnant women with heart disease in an economically advantageous region of a developing country.Design and methods: A cross-sectional study was conducted using data from the Weekly Report of Obstetrics and Gynaecology Department to assess pregnant women with heart disease characteristics and pregnancy outcomes. A total sample of 69 pregnant women with heart disease regarding their gestational age was included in the study. Variables observed were maternal characteristics, heart disease's clinical parameters, and maternal and neonatal outcomes. Chi-square test was used to examine the different characteristics of congenital and acquired heart disease groups.Results: The prevalence of cardiac disease in pregnancy was 5.19%. Fifty-three point six percent of pregnant women with heart disease were suffered from congenital heart disease (CHD), while 46.4% were acquired heart disease (AHD). Most labor methods were Cesarean delivery, and 69.6% of women experienced cardiac complications. Maternal death was reported in 8.69% of cases. Four cases were CHD complicated by pulmonary hypertension, which leads to Eisenmenger syndrome. Two other cases were AHD complicated by Peripartum Cardiomyopathies. Although statistically insignificant, complications are more common in the AHD group than CHD.Conclusion: Cardiac disease prevalence in pregnancy is considered high, with CHD as the most common case, which significantly differs from other developing countries.

scholarly journals Clinical outcomes among pregnant patients with cardiac disease only and those with co-existing pregnancy-associated hypertension

2018 ◽  
Vol 7 (8) ◽  
pp. 3288
Author(s):  
Karishma Gupta ◽  
Arthika Shetty ◽  
Madhva Prasad ◽  
Alka S. Gupta
Keyword(s):  
Heart Disease ◽  
Clinical Outcomes ◽  
Gestational Age ◽  
Cardiac Disease ◽  
Severe Hypertension ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Gestational Age At Delivery ◽  
The Impact ◽  
Control Study

Background: Impact of cardiac disease on pregnancy is significant. Impact of hypertension on pregnancy is also significant. “Does occurrence of hypertension along with cardiac disease worsen the outcomes?” forms the crux of this study. The aim of the present study was to determine the impact of pregnancy-associated hypertension on the clinical outcomes of pregnant patients with cardiac disease.Methods: Retrospective, observational, comparative, case control study of one and half year duration conducted in a tertiary care referral hospital. The various medical and obstetric parameters were studied and compared.Results: Among 143 patients studied, 36 were hypertensive and 107 were non-hypertensive. Non-severe hypertension was seen in 17%, severe hypertension in 4% and eclampsia in 4%. Average age was 26 years and majority were first or second gravida. Valvular heart disease was the most common cardiac disease encountered. Gestational age at delivery, perinatal outcome and occurrence of pulmonary hypertension were all similar in both the hypertensive and non-hypertensive groups.  The most common mode of delivery was vaginal delivery. The cesarean section rate was 29% and was similar among both hypertensive and non-hypertensive groups. Requirement for induction of labor, occurrence of small-for- gestational age among the newborns, intensive care unit admission due to heart failure and maternal death was higher (statistically significant (p<0.05) among the hypertensive group.Conclusions: Presence of hypertension worsens outcomes among pregnant patients with cardiac disease. The coexistence of hypertension and cardiac disease should alert the obstetrician and specialist physician towards a more vigilant management. The findings of this study may help risk stratification (development of pregnancy associated hypertension) while counseling patients with heart disease. 

scholarly journals Study of spectrum of cardiac disease complicating pregnancy and the maternal and foetal outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4803
Author(s):  
Sudha R. ◽  
Anjali R.
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Cardiac Complications ◽  
Team Approach ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
Foetal Outcome ◽  
Grade Iii

Background: Heart diseases are the most important non obstetrical causes of maternal deaths during pregnancy, accounting for almost 10% of maternal deaths. They complicate 1-3% of all pregnancies.Methods: The study was conducted at Cheluvamba Hospital from January 2015 till July 2016. All pregnant women with cardiac disease were included in the study. Pregnant women with cardiac disease were followed up during antenatal period, evaluated and maternal and foetal outcome was studied.Results: Total number of deliveries in the one and half year study period was 18,803 cases and the total number of women with cardiac disease was 90. Most of the subjects belonged to NYHA grade I and II (95.5%), whereas NYHA grade III and IV constituted only 4.4% of cases. Rheumatic heart disease was the principal cardiac lesion (62.22%) among the pregnancies, while congenital heart disease (33.33%) was the second most common cause. 16.7% had cardiac complications and there were 2(2.22%) maternal mortality. 91.86% were live births with 5.88% IUDs and 2.35% neonatal deaths. 15.29% of the babies were Preterm, 8.14% were IUGR babies and 2.35% had congenital anomalies. It was noted NYHA grade III/IV cases had more preterm babies compared to NYHA grade I/II. NICU admissions were also more with NYHA grade III/IV.Conclusions: The results suggest the need for pre-pregnancy counselling, early diagnosis, correction of cardiac lesions where indicated, close surveillance during pregnancy and a team approach comprising of obstetricians, cardiologists, neonatologists and nursing personnel for a successful pregnancy outcome.

scholarly journals Study of Maternal and Fetal Outcome in Pregnancy with Heart Disease

2017 ◽  
Vol 8 (2) ◽  
pp. 112-116 ◽  
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

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.

scholarly journals The association between guidelines adherence and clinical outcomes during pregnancy in a cohort of women with cardiac co-morbidities

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255070
Author(s):  
Sandra Millington ◽  
Suzanne Edwards ◽  
Robyn A. Clark ◽  
Gustaaf A. Dekker ◽  
Margaret Arstall
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Clinical Outcomes ◽  
Mode Of Delivery ◽  
Decompensated Heart Failure ◽  
Trial Registration ◽  
Cardiac Complications ◽  
Cross Sectional ◽  
Clinical Variables ◽  
Adherence Score

Background/Aims Maternal and infant morbidities associated with pregnant women with cardiac conditions are a global issue contingent upon appropriate care. This study aimed to describe the clinical variables and their association with the adherence scores to perinatal guidelines for pregnant women with cardiac conditions. The clinical variables included cardiac, perinatal, and neonatal outcomes and complications. Methods Using a retrospective cross-sectional medical record audit, data were abstracted and categorised as cardiac, obstetric, and neonatal predictors. Linear regression modelling was used to find the mean difference (MD) in adherence scores for each predictor, including a 95% confidence interval (CI) and a significance value for all the three categories’ clinical outcomes. Results This maternal cohort’s (n = 261) cardiac complications were primarily arrhythmias requiring treatment (29.9%), particularly SVT (28%), a new diagnosis of valvular heart disease and congenital heart disease (24%) and decompensated heart failure (HF) (16%). Women with HF had associated increased adherence scores (MD = 3.546, 95% CI: 1.689, 5.403) compared to those without HF. Elective LSCS mode of delivery was associated with a higher adherence score (MD = 5.197, 95% CI: 3.584, 6.811) than non-elective LSCS subgroups. Babies admitted to intensive /special care had greater adherence to the guidelines (MD = 3.581, 95% CI: 1.822, 5.340) than those not requiring the same care. Conclusions Some pregnancy associated complications and morbidities were associated with higher adherence scores, reflecting that a diagnosis, identification of morbidities or risk factors, initiation of appropriate multidisciplinary involvement and adherence to guidelines were associated. Conversely, potentially avoidable major complications such as sepsis were associated with a low adherence score. Trial registration ACTRN12617000417381.

scholarly journals Maternal and perinatal outcomes of pregnancies complicated by cardiac disease at tertiary level hospital of Uttarakhand

2017 ◽  
Vol 6 (8) ◽  
pp. 3338
Author(s):  
Priyanka Chaudhari ◽  
Vineeta Gupta ◽  
Nidhi Kumari ◽  
Archna Tandon ◽  
Nimisha Gupta
Keyword(s):  
Heart Disease ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Nyha Class ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Cardiac Diseases ◽  
Class Iii ◽  
Maternal Deaths ◽  
Common Cause

Background: Cardiac disease is the most common cause of indirect maternal deaths and most common cause of death overall. It complicates 1% of all maternal deaths. The maternal and neonatal risks associated with pregnancy in women with cardiac disease receiving comprehensive prenatal care have not been well defined. Objective of present study was to evaluate the burden of cardiac diseases in pregnancy in our hospital, their clinical presentation, type of cardiac lesion, associated complications, maternal and fetal outcome.Methods: A retrospective study was conducted in Obstetrics and gynecology department at Shri Guru Ram Rai Institute of medical and health sciences, Dehradun from January- 2013 to December-2015. All patients with cardiac diseases during pregnancy or developed during postpartum period were included in the study. Detailed Demographic profile of patients, mode of delivery, perinatal outcome, associated antenatal, intranatal and postnatal complications were analyzed in detail.Results: There were 37 patients with cardiac disease during pregnancy in our study period. Out of these 32.4% were diagnosed during current pregnancy. Rheumatic heart diseases were seen in 54.05% patients and congenital heart disease seen in 35.1%. out of these 81.1% patients belonged to NYHA class I and II and 18.9% patients in class III & IV. Majority of patients (78.3%) had vaginal delivery. We observed 5.4% maternal mortality and 2.7% of neonatal mortality rate.Conclusions: Pregnancy in women with heart disease is associated with significant cardiac and neonatal complications. Multidisciplinary approach involving cardiologist, obstetrician and neonatologist improves fetomaternal outcome.

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