Pregnancy Complicated By Maternal Heart Disease: A Clinical Study At A Tertiary Referral Centre

Abstract

Background: Heart disease remains a leading cause of indirect maternal deaths during pregnancy accounting for 20% of all cases. Many significant circulatory changes accompany pregnancy in women with preexisting cardiovascular disease, these alterations in haemodynamics can be dangerous. Therefore, patients should be evaluated for underlying cardiac disease to select appropriate management. Aims: The aim of this study is to evaluate the influence of biological factors in Maternal and Perinatal Outcome in Heart Disease Complicating Pregnancy. Materials and Methods: Department of Obstetrics and Gynecology, Sri Krishna Medical College & Hospital (SKMCH), Muzaffarpur, Bihar from Sep 2020 to Aug 2022 on 50 pregnant women with heart disease. Results: Based on age among the pregnant women with heart disease, about 38% were in the age group of 21 to 25 years. Gestational age of the pregnant women at the time of admission to the hospital was studied: 66% of the patients belong to term gestation. Preterm labour accounted to 32% & 1 women with heart disease was referred to our hospital as post-dated. Majority of the cases with heart disease were referred with antenatal check-up elsewhere i.e., outside government hospital 84% and 62% of the patients had cardiac disease diagnosed prior to present pregnancy. The cardiac functional status of the pregnant women with heart disease at the time of admission to the hospital was studied: Most of the patients have stable cardiac status and they fall under class I- i.e., 66%. 18% of the pregnant women belong to NYHA class II, 10% belong to NYHA class III and 6% of the cases belong to NYHA class IV at the time of admission. Conclusion: Heart disease is the most common non-obstetric cause of maternal morbidity and mortality. It also has a major impact on neonatal outcome. Favourable outcome is noted in women with NYHA class I and II, avoidance of factors precipitating heart failure like anemia, infections, arrhythmias, regular cardiac follow up, strict adherence to cardiac medications.