Cardiac Disease complicating Pregnancy: A Tertiary Care Center Experience

2017 ◽  
Vol 3 (2) ◽  
pp. 41-44
Author(s):  
R Nagarathnamma ◽  
C Sarojamma ◽  
P Sneha
Keyword(s):  
Cardiac Disease ◽  
Intrauterine Growth Restriction ◽  
Neonatal Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Adverse Outcomes ◽  
Tertiary Care Center ◽  
Maternal Complications ◽  
Intrauterine Growth

ABSTRACT Introduction Cardiac disease in pregnancy is a major problem worldwide, particularly in developing countries. It often poses a difficult clinical scenario with the responsibility of the treating obstetrician also extending to the unborn fetus. In the present study, we aim to know the maternal and fetal outcomes in pregnancies complicated by cardiac disease. Materials and methods All pregnant patients with cardiac disease who delivered at our institution during 2014 to 2016 were evaluated to look for the final pregnancy outcomes. Results Out of 36 study cases, 44.44% had no maternal complications, while 88.89% had good fetal/neonatal outcome. The commonest maternal cardiac complication was sustained tachyarrhythmia/bradycardia followed by pulmonary edema, while intrauterine growth restriction was encountered in fetal outcome. Conclusion Multidisciplinary team management of cardiac disease, led by an experienced obstetrician and cardiologist, reduces the adverse outcomes in pregnancies complicated by cardiac diseases. How to cite this article Sneha P, Sarojamma C, Nagarathnamma R. Cardiac Disease complicating Pregnancy: A Tertiary Care Center Experience. J Med Sci 2017;3(2):41-44.

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 Obstetrics outcome in pregnant women with cardiac disease in tertiary care center, Dehradun - India

2019 ◽  
Vol 9 (1) ◽  
pp. 313
Author(s):  
Prachi Singh ◽  
Namrata Saxena ◽  
Vineeta Gupta ◽  
Neeta Bansal ◽  
Yashika Pehal
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Cardiac Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Disease Patient ◽  
Pregnant Patient ◽  
Fetal Outcome ◽  
Reproductive Age ◽  
Tertiary Care Center

Background: Incidence of heart disease in pregnancy is about 1%. Pregnant patient with cardiac disease can present with lot of challenges for the obstetrician, paediatrician and the cardiologist. With improvement in diagnostic, medical, surgical management, more patient with cardiac diseases especially congenital are able to reach reproductive age. Therefore, still a cardiac disease remains a significant cause of maternal death. Maternal and fetal prognosis both is affected by the care given and the skills used in the treatment of the individual patient. Hospital has resulted in majority of cardiac disease patient being managed in a tertiary care center and this provide an opportunity to report on clinical experiences of pregnancy with cardiac disease, their management and obstetrical outcomes.Methods: This was a retrospective study, with all the patients detailed demographic information, diagnosis, course in the hospital, management, maternal and fetal outcome was obtained from the medical records and files.Results: Incidence of cardiac disease was found to be 0.7%, 47% of pregnant women fell in age group of 26-30 years, 38.2% were primigravida, only 23.53% were booked, and half of them belonged to NYHA II class. 73.5% had Rheumatic heart disease and the most common obstetrics complications were preterm labor and anemia. LSCS was done in 29.4% cases and 38.2% of the newborns were premature.Conclusions: Prematurity anaemia, IUGR, are the common obstetrical complication in pregnant patient with cardiac disease which can be taken care with increased awareness and pre-conceptional counselling especially in patient with congenital heart disease. For optimization of maternal and neonatal outcomes in these patients, dedicated team of obstetrician, fetal medicine specialist, pediatricians, cardiologist and anesthesiologist is the prime requirement.

Scenario of General Anesthesia for Cesarean Section in Rural Tertiary Care Center in High Altitude Karnali Academy of Health Sciences

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Ramesh Bhattarai ◽  
Rajiv Shah ◽  
Sita Dhakal ◽  
Pragya Malla ◽  
Srijana Sapkota
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
High Altitude ◽  
Spinal Anesthesia ◽  
Neonatal Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Health Sciences ◽  
Tertiary Care Center ◽  
Cord Prolapse

Background: General anesthesia for cesarean section is being less popular for cesarean section in present days but sometime general anesthesia is inevitable. The aim of the study is to assess the trends of general anesthesia, indications, clinical outcome in mother and fetus in high altitude setting of tertiary care center of Nepal. Methods: We conducted descriptive cross-sectional study all cases of cesarean section in Karnali Academy of health Sciences (KAHS) located at high altitude over three years period   in our institute. Data were retrieved from the hospital records during three fiscal year (Jan 1st 2017 to Jan Dec 31st 2019). The record of all the patients who underwent cesarean section under general anesthesia was reviewed for demographic details, indication of general anesthesia, trends for general and spinal anesthesia and maternal and neonatal outcome. Results: Out of total deliveries 2175, 309 (14.2%) cases account for cesarean section. Among them, 52 (17%) required general anesthesia . Eclampsia 19(36%) remain the major indication for General Anesthesia in cesarean section followed by failure of spinal anesthesia number 14 (26%) , cord prolapse six (12%), antepartam haemorrhage five (10%), spinal site infection four (8%), Khiphoscoliosis two(4%), Patients request  two (4%). Use for general anesthesia technique was consistent for three years with slow rise in use of spinal anesthesia . There was no any anesthesia related maternal mortality and nine intraoperative neonatal   Conclusions:  General anesthesia practices are consistently required in rural high-altitude setup. Eclampsia is the commonest indication followed by failure of spinal anesthesia and cord prolapse. Neonatal outcome is still not good.  

A study of peripartum cardiomyopathy in a tertiary care center in India

2017 ◽  
Vol 6 (2) ◽  
pp. 523 ◽  
Author(s):  
Aditi V. Joshi ◽  
Michelle N. Fonseca ◽  
Deepali S. Kharat-Kapote
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Peripartum Cardiomyopathy ◽  
Early Interventions ◽  
Tertiary Care Center ◽  
Common Risk Factor ◽  
The Mean ◽  
Time Of Presentation ◽  
Underlying Pathogenesis

Background: Peripartum cardiomyopathy is an idiopathic and reversible form of dilated cardiomyopathy. The aim of the study was to study the mean age of presentation of peripartum cardiomyopathy in pregnant patients over a period of 1 year in a tertiary health care and study the maternal and fetal outcome of patients with peripartum cardiomyopathy.Methods: A retrospective observational study with total of 22 patients with peripartum cardiomyopathy was diagnosed in a total of 10,279 deliveries conducted at LTMMC, Sion hospital between September 2014 to February 2016.Results: Our study revealed that most of the affected patients were young with the mean age at presentation being 26.8±4.29 years. Most of the patients were diagnosed in the postpartum period (63.6%). the most common risk factor was pre-eclampsia (22.7%) followed by anemia (18.2%). The mean Ejection fraction at the time of presentation was 25.3±9.8%. There were 2 (9.1%) intrauterine fetal deaths and 1 neonatal death.Conclusions: There is a need for more multi-centric studies in order to understand the underlying pathogenesis and to determine the possible early interventions to help provide better pregnancy outcome.

scholarly journals Fetomaternal outcome in pregnancy with HELLP syndrome

2020 ◽  
Vol 9 (7) ◽  
pp. 2860
Author(s):  
Prachi M. Shelat ◽  
Rupa C. Vyas ◽  
Sapana R. Shah ◽  
Naimish D. Nathwani
Keyword(s):  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Care Center ◽  
Tertiary Care ◽  
Peripheral Blood Smear ◽  
Intrauterine Death ◽  
Tertiary Care Center ◽  
Maternal Complications ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

Background: HELLP Syndrome is a serious complication of pregnancy induced hypertensive disorders. It is defined as a triad of hemolysis, elevated liver enzymes, and low platelet count (HELLP). Objectives of this study was to find out incidence of HELLP syndrome in pre-eclampsia, eclampsia and its overall incidence. To analyse the clinical profile of HELLP syndrome. To study maternal and perinatal outcome including morbidity and mortality.Methods: A retrospective study was conducted from July 2017 to September 2019 at a tertiary care center with inclusion criteria of abnormal peripheral blood smear, elevated liver enzymes (LDH, aspartate aminotransferase), and low platelet count.Results: HELLP syndrome was more common in younger age group (45%) and in primigravida (52.5%). Most of the patients presented at >36 weeks of gestation (40%) and most of the patients delivered by caesarean section (67.5%). Maternal complications were acute renal failure (27.5%), DIC (22.5%), maternal mortality (7.5%). Neonatal complications associated were intrauterine death (27.5%), prematurity (25%) and intrauterine growth retardation (15%).Conclusions: Thus, HELLP syndrome requires an early diagnosis and early initiation of treatment at tertiary care center with all the medical facilities available.

scholarly journals Fetal brain MRI findings and neonatal outcome of common diagnosis at a tertiary care center

2019 ◽  
Vol 39 (8) ◽  
pp. 1072-1077 ◽  
Author(s):  
Monica S. Arroyo ◽  
Robert J. Hopkin ◽  
Usha D. Nagaraj ◽  
Beth Kline-Fath ◽  
Charu Venkatesan
Keyword(s):  
Neonatal Outcome ◽  
Care Center ◽  
Brain Mri ◽  
Tertiary Care ◽  
Fetal Brain ◽  
Tertiary Care Center ◽  
Mri Findings ◽  
Common Diagnosis

scholarly journals Peri-partum cardiomayopathy-not a rare entity, clinical profile in a rural tertiary care center in Gujarat, India

2017 ◽  
Vol 6 (4) ◽  
pp. 1544 ◽  
Author(s):  
Rumi Bhattacharjee ◽  
Nitin Raithata ◽  
Molina Patel ◽  
Smruti Vaishnav
Keyword(s):  
Heart Failure ◽  
Care Center ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Fetal Outcome ◽  
Obstetric Complications ◽  
Tertiary Care Center ◽  
Diagnostic Dilemma ◽  
High Risk Factors ◽  
High Index Of Suspicion

Background: Peri-partum cardiomayopathy (PPCM) in pregnancy has a potential to adversely affect both mother and fetus. Severe cases can be associated with life threatening complications unless managed promptly by multidisciplinary team. The objective was to study maternal and fetal outcome of PPCM patients.Methods: An observational cohort over 4 years (2012 to 2015) was conducted in a Rural tertiary care center. Consecutive antenatal and postpartum women with PPCM were studied for medical and obstetric complications, deliveries, fetal outcome and maternal mortality.Results: The incidence of PPCM was 0.3% and Most patients presented with typical signs and symptoms of heart failure. 55.5% were in NYHA 3 and 4 and 50% had ejection fraction below 30%. 83.3% required ICU admissions of varying length and Maternal mortality was in 1 patient (5.56%). PPCM occurred in 55.5% of ante partum against 44.4% of postpartum patients. Obstetric complications like PPH occurred in 11.1% while poor fetal outcome like preterm deliveries occurred in 50% while still births in 16.67%.Conclusions: The low incidence and rarity of PPCM presents itself with diagnostic dilemma. Obstetrician should have high index of suspicion in patients with heart failure and high risk factors. Early diagnosis and prompt treatment can only improve the outcome.

scholarly journals Retrospective analysis of breech deliveries in tertiary care center

2020 ◽  
Vol 9 (11) ◽  
pp. 4549
Author(s):  
Suneela Mullakkal Sankaran ◽  
Jayasree Sukumara Sukumara Pillai
Keyword(s):  
Intrauterine Growth Restriction ◽  
Caesarean Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Growth Restriction ◽  
Cross Sectional ◽  
Intrauterine Growth ◽  
Uterine Anomalies

Background: Breech presentation is the commonest malpresentation accounting for 3-4% of all deliveries at term. The most common cause for breech presentation is preterm delivery. The safest route of delivery for breech had long been a topic of debate and after the results of term breech trial mode of delivery has become abdominal route even in teaching institutions.Methods: This is a retrospective cross sectional study conducted at department of obstetrics and gynaecology, Government medical college, Kozhikode, for a period of 2 years from 01 January 2016 to 31 December 2017. Mothers with gestational age between 28 weeks to 41 weeks with singleton live fetus with breech presentation who had either vaginal or caesarean delivery were included. The case notes were retrieved from the medical records department.Results: A total of 823 breech deliveries occurred during the study period. Of the total mothers 429 were primies and 394 were multies. Common causes identified were prematurity, intrauterine growth restriction, uterine and fetal anomalies. Mode of delivery was caesarean in more than 80% of cases.Conclusions: Incidence of breech presentation was 3.2% during the study period. Increasing incidence of caesarean delivery is seen in breech presentation. Persistent breech presentation at term is most commonly seen in patients with associated oligamnios, intrauterine growth restriction, and uterine anomalies.

scholarly journals Prevalence of pre-gestational diabetes among the antenatal women attending a tertiary care center

2017 ◽  
Vol 6 (3) ◽  
pp. 797 ◽  
Author(s):  
Renji S. R. ◽  
Sujatha Thankappan Lekshmi ◽  
Nirmala Chellamma
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Statistical Tests ◽  
Care Center ◽  
Tertiary Care ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Tertiary Care Center ◽  
Family History Of Diabetes ◽  
History Of

Background: Number of pregnant women with preexisting diabetes is increasing. Hence the detection and management of diabetes from the beginning of pregnancy itself will help to improve the fetal and maternal outcome. Aim of the study was to determine the prevalence of pre-gestational diabetes among the antenatal women attending a tertiary care center and to study the associated factors.Methods: This was a cross sectional study conducted in SAT hospital, Government Medical College, Trivandrum, Kerala, India for one year. HbA1C was the test used to diagnose diabetes. 400 women attending the OP in their first trimester were selected after informed consent. Socio demographic factors assessed by a structured questionnaire.  Blood samples were taken for HbA1C. Diagnosis of diabetes was made at levels of HbA1C ≥6.5%. Statistical tests used were mean, standard deviation, chi-square and odds ratio.Results: Prevalence of pre-gestational diabetes was 3.8%.in our study. Main associations were age more than 25 years, body mass index, family history of diabetes, history of intra uterine death, gestational diabetes in previous pregnancy, candidiasis and thyroid disease.Conclusions: Screening of all pregnant women in first trimester itself for diabetes will help in early detection of pre-gestational diabetes, so that anticipation of adverse outcomes and proper management can be done in such cases.

scholarly journals Maternal hypothyroidism and neonatal outcome

2018 ◽  
Vol 5 (2) ◽  
pp. 600
Author(s):  
Shravani M. R. ◽  
Tharashree C. D. ◽  
Yashodha H. T.
Keyword(s):  
Early Diagnosis ◽  
Universal Screening ◽  
Prospective Observational Study ◽  
Neonatal Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Overt Hypothyroidism ◽  
Tertiary Care Center ◽  
Timely Initiation ◽  
Targeted Screening

Background: Hypothyroidism is widely prevalent in pregnant women and the rate of detection, especially in a developing country like India, has not kept pace with the magnitude of the problem. The present study was conducted to evaluate thyroid function in neonates born to mothers with hypothyroidism.Methods: A prospective observational study was conducted in KIMS Hospital Tertiary care center for 6 months. A total of 106 neonates born to mothers with hypothyroidism were included in the study. Thyroid functions of these babies were assessed at 72 hours of life.Results: In present study, 11.8 % of mothers were hypothyroid of which 87 % were subclinical hypothyroidism and 13 % of overt hypothyroidism due to adaptation of universal screening rather than targeted screening for hypothyroidism which would otherwise go unrecognised and untreated.Conclusions: All the babies had normal TSH and T4 levels which was probably due to early diagnosis and timely initiation of treatment to the mothers with hypothyroidism. 

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