Heart disease in pregnancy: cardiac and obstetric outcomes.

Abstract

BACKGROUND:

A retrospective analysis of the records of all the patients of heart disease with pregnancy at AIIMS, New Delhi, India, to find out the maternal and fetal outcome.

MATERIALS AND METHODS:

A retrospective analysis was carried out of 100 pregnancies in women with heart disease who delivered at ≥28 weeks of gestation from July 2009 through August 2012.

RESULTS:

Cardiac disease was found to complicate 3.8 % of pregnancies. Rheumatic heart disease (n = 64, 64 %) was the predominant cardiac disease. Congenital heart disease was found to complicate 36 pregnancies (n = 36, 36 %).Cardiac complications were seen in 32 (32 %) and fetal complications in 18 (18 %) pregnancies. Fewer cardiac and postpartum complications were present in NYHA class I/II patients compared to NYHA III/IV patients (P < 0.05). Pregnancy outcome was better in rheumatic heart disease patients who had undergone cardiac intervention prior to pregnancy (n = 29, 45.2 %) compared to those whose heart disease remained uncorrected (n = 35, 54.8 %) but the difference was not statistically significant. There was one maternal mortality in a patient with Eisenmenger syndrome. Two of the newborns of the 17 women who had received anticoagulants had features of warfarin embryopathy.

CONCLUSION:

Pregnancy in women in NYHA class III/IV is associated with significantly higher maternal morbidity and cardiac interventions before pregnancy, when indicated may improve pregnancy outcome.

• Authors: Murali Subbaiah, Vaishali Sharma, Sunesh Kumar, S Rajeshwari, Shyam Sunder Kothari, Kallol Kumar Roy, Jai Bhagwan Sharma, Neeta Singh
• Journal: Archives of gynecology and obstetrics (Arch Gynecol Obstet) Vol. 288 Issue 1 Pg. 23-7 (Jul 2013) ISSN: 1432-0711 [Electronic] Germany
• PMID: 23377177 (Publication Type: Journal Article)

Chemical References

• Anticoagulants
• Warfarin

Topics

• Adult
• Anticoagulants (adverse effects)
• Aortic Valve
• Birth Weight
• Female
• Fetal Diseases (chemically induced)
• Fetal Growth Retardation (etiology)
• Heart Defects, Congenital (complications)
• Heart Valve Diseases (complications)
• Humans
• Mitral Valve
• Pregnancy
• Pregnancy Complications, Cardiovascular (drug therapy, etiology)
• Pregnancy Outcome
• Retrospective Studies
• Rheumatic Heart Disease (complications, therapy)
• Severity of Illness Index
• Warfarin (adverse effects)
• Young Adult