“Impact Of Maternal Cardiac Disease On Pregnancy Outcome & To Study Predictors Of Cardiac Events”

Abstract

Objective:To study the effect of maternal heart disease on pregnancy outcomes in terms of maternal and perinatal morbidity with the predictors of cardiacevents during pregnancy.Setting:High risk Obs. Unit at tertiary care superspecalityhospital,Wanless Mission Hospital, Miraj. Design:Prospectiveobservational study.Duration: June2012 to June 2014.Subjects andMethod:All diagnosed cases of congenital and acquired heart diseases were included& were followed during ANC period upto the time of delivery. Newly diagnosed cases during pregnancy were excluded.Primary outcome measures were maternal complications relating to cardiovascular system & immediate perinatal outcome. Secondary outcome measures were associated predictors of poor maternal outcome & mode of delivery. Results:Baseline characteristics: Total 50 cases were enrolled.Maximum cases,41(82%) were between age group of 21 to 30 years, 36(72%) were para one &two.Out of 50 cases 38(76%) were rheumatic heart diseases, 9(18.10%) congenital heart diseases & 3 others(cardiomyopathy,ventricular tachycardia ,heart block).Mitral stenosis was the commonestlesion with ASD & VSD being common amongst congenital heart diseases.Sixteen cases had cardiac surgical intervention either during or before pregnancy.Primary outcome: All maternal cardiac complications occurred in Group II(NYHA III&IV) with Pulmonary edema in 5,congestive cardiac failure in 2 ,atrial fibrillations in 1case.There was no maternal mortality.Out of 42 group I cases,10 (13.8%)babies had IUGR, 2(2.5%) preterm & 2(2.5%) stillbirth. Out of 8cases in group II cases,3(36.5%) babies had IUGR,prematurity in 5(62.5%).Secondary outcome: NYHA class >II, obstructive lesions of heart, significant cardiac complications prior to pregnancy, ejection systolicfraction