scholarly journals FETOMATERNAL OUTCOME IN PREGNANCY WITH CARDIAC DISEASE

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

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 Feto-maternal outcome study in hypertensive disorders of pregnancy: primigravida vs multigravida

2021 ◽  
Vol 10 (3) ◽  
pp. 920
Author(s):  
Jaydeb Mandal ◽  
Dibyendu Roy
Keyword(s):  
Birth Weight ◽  
Maternal Morbidity ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Outcome Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Maternal Morbidity And Mortality

Background: Approximately 7-10% of all pregnancies are complicated by some form of hypertensive disorders. Hypertensive disorders of pregnancy (HDP) are major cause of maternal morbidity and mortality as well as fetal complications. This study is aimed to determine and compare the maternal and perinatal outcomes of hypertensive pregnancies in between primigravida and multigravida.Methods: After taking college ethical committee permission a prospective comparative study was done in our medical college from January 2017 to April 2017 with 300 women having HDP from 3658 admitted patients in that time. They were enquired and followed up as per questionnaire till their discharge from the hospital. Among study women 174 women were primigravida, 126 were multigravida. The prevalence of maternal events and complications like eclampsia, IUGR, preterm labour (PTL), HELLP syndrome DIC, mode of delivery and fetal events like Apgar’s score, birth weight were studied and compared among primigravida and multigravida. All the events related to pregnancy outcomes were analyzed statistically.Results: Our study shows prevalence of HDP was 8.2% of total admitted patients, of them 58% were primigravida, 42% multigravida. Primigravida compared to multigravida had a higher tendency to have IUGR, PTL. DIC is also slightly more in primigravida but placental abruption and PPH were more in multigravida. Fetal outcome study showed babies born with low birth weight is significantly more in primigravida and higher incidence of severe asphyxiated babies were born in primigravida. More than 40% primigravida were terminated by caesarean section, most of them had emergency indication.Conclusions: Primigravidas are more sufferer to HDP and its complications. Comprehensive antenatal care at the same time strict vigilance during delivery and quality postnatal care of high risk patients specially primigravida group could significantly reduce maternal morbidity and mortality and improves fetal outcome.

scholarly journals MATERNAL SEPSIS;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Fehmida Parveen Memon ◽  
Majida Khan ◽  
Samya Aijaz
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Maternal Morbidity And Mortality ◽  
Maternal Sepsis

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.

scholarly journals Maternal Outcome in Mitral Valve Disease with Pulmonary Hypertension: Two Case Reports

2018 ◽  
Vol 03 (02/03) ◽  
pp. 204-208
Author(s):  
Anuradha Alagandala ◽  
Daya Vaswani ◽  
Vuduthala Bharadwaj ◽  
Kousalya Chakravarthy
Keyword(s):  
Pulmonary Embolism ◽  
Heart Disease ◽  
Mitral Stenosis ◽  
Maternal Morbidity ◽  
Fatal Case ◽  
Morbidity And Mortality ◽  
First Case ◽  
Asymptomatic Patients ◽  
Maternal Morbidity And Mortality ◽  
In Pregnancy

AbstractChronic rheumatic heart disease is still the leading cause of heart disease complicating pregnancy in the developing countries. The physiologic changes in pregnancy and stress induced by the increase in cardiac output can cause asymptomatic patients with mitral stenosis to decompensate, especially in the third trimester. Severity of mitral stenosis is reflected by the decrease in the valve area and increase in the right ventricular systolic pressures (RVSPs). Venous thromboembolism (VTE) is two to five times more common in the postpartum period, and the risk is high with cesarean delivery. Pulmonary embolism in pregnancy can cause severe maternal morbidity and mortality. We describe two cases of severe mitral stenosis complicating pregnancy with grossly elevated RVSP. The first case is the successful management of a second gravida, presenting with severe mitral stenosis with RVSP 80 mm Hg, and the second, a fatal case of a 26-year-old para 1, live 1, delivered by cesarean section, presenting with massive fatal pulmonary embolism on 13th postoperative day (POD) with RVSP 90 mm Hg. A multidisciplinary approach involving the cardiologist, obstetrician, and obstetric anesthesiologist is crucial for management of severe mitral stenosis complicating pregnancy, to decrease the maternal morbidity and mortality during peripartum period.

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.

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 Finding Understudied Disorders Potentially Associated with Maternal Morbidity and Mortality

2019 ◽  
Vol 09 (01) ◽  
pp. e36-e43 ◽  
Author(s):  
Laritza Rodriguez ◽  
Dina Fushman
Keyword(s):  
Intensive Care ◽  
Clinical Research ◽  
Maternal Morbidity ◽  
Medical Information ◽  
Research Literature ◽  
Morbidity And Mortality ◽  
Control Group ◽  
Maternal Complications ◽  
Maternal Morbidity And Mortality ◽  
Discharge Summaries

Objective Clinical research literature focuses primarily on the most common causes of maternal morbidity and mortality (MMM). We explore sections of the discharge summaries of pregnant or postpartum women admitted to an intensive care unit (ICU) to identify associated disorders and mine the literature to identify knowledge gaps in clinical research. Methods Data for the study were discharge summaries in the MIMIC (Medical Information Mart for Intensive Care) database. We extracted a control cohort to study if there is a difference in comorbidities between pregnant and not pregnant patients with similar reasons for admission. We identified comorbidities of the Unified Medical Language System (UMLS) semantic types disease or syndrome, Mental or behavioral dysfunction, and injury, or poisoning. We used Entrez programming utilities (E-utilities) to query PubMed®. Results We identified 246 pregnant and postpartum patients. A control group of 587 not pregnancy related admissions matched on age and admit diagnosis. We found overlap of 24.3% discharge diagnoses between the two groups, and 7.5% of the codes exclusively in the pregnancy group. We identified 33 disease mentions not included in the most common reported causes of MMM. Conclusion Our results demonstrate that clinical text provides additional comorbidities associated with maternal complications that need further clinical research.

scholarly journals Maternal and perinatal outcome in heart disease complicating pregnancy

2021 ◽  
Vol 10 (10) ◽  
pp. 3725
Author(s):  
Tanvi Kumar ◽  
Rishman Tandi ◽  
Amritaa Thalla
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Heart Disease ◽  
Cardiac Disease ◽  
Perinatal Outcome ◽  
Heart Diseases ◽  
Nyha Class ◽  
Morbidity And Mortality ◽  
Elective Cesarean Section ◽  
Perinatal Morbidity

Background: Congenital as well as acquired heart diseases remain one of the important factors complicating pregnancy and remains a significant cause of maternal as well as perinatal morbidity and mortality. Pregnant women with cardiac diseases need a comprehensive management strategy to minimize the adverse effect of cardiac conditions on pregnancy and its outcome.Methods: This was an observational study conducted in a tertiary care hospital located in an urban area. Pregnant patients diagnosed to be having congenital or acquired heart diseases and admitted either in ward, labour room or intensive care unit were included in this study on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and clinical examination was done in all the cases. Patients were classified according to New York Heart Association. Maternal and perinatal Outcome was studied in cases.Results: The incidence of cardiac disease amongst pregnant patients during study period was found to be 0.58%. The mean age of studied cases was found to be 23.16±5.06 years. Most of the patients were primigravida (85.71%) and 6 patients (14.29%) were multigravida. The majority of the patients (76.19%) belonged to NYHA grade I whereas 8 (19.05%) patients belonged to NYHA class II. 1 patient belonged to NYHA Class III and Class IV respectively. Isolated mitral stenosis secondary to rheumatic valvular involvement was the single most common lesion seen in studied cases and was seen in 8 (19.05%) patients. Ventricular septal defect was most common congenital heart disease (14.28%). 26 (61.90 %) delivered by normal vaginal delivery whereas emergency and elective LSCS was done in 9 (21.43%) and 6 (14.29%) patients respectively. nature of cardiac disease was common factor for elective cesarean section which was done in 5 cases (11.90%). Postpartum cardiac failure (14.29%) and postpartum hemorrhage (9.52%) were common maternal complications. 24 (57.14%) neonates required admission in neonatal intensive care unit. The most common indication for NICU admission was found to be low birth weight (23.81%) followed by birth asphyxia (19.05%).Conclusions: Cardiac disease in pregnancy is associated with increased risk of maternal as well as perinatal morbidity and mortality. Early diagnosis and management during pregnancy is essential to reduce maternal as well as perinatal outcome in these cases.

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