A clinical study on maternal heart diseases complicating pregnancy at tertiary care hospital
Shyamsundar B, Vinayraju D,Seeta Garag
Background: Cardiac diseases complicate 1- 4% of pregnancies in women without pre-existing cardiac abnormalities. Cardiac disease in the pregnant woman can present a challenge to the obstetrician, cardiologist and neonatologist. Objectives: Aim is to study the burden of the disease, maternal and neonatal outcome in the cardiac disease complicating pregnancy. Methods: This study is a prospective observational study conducted among the antenatal women admitted in the department of OBG at KIMS, Hubli with a previously diagnosed cardiac disease or diagnosed after admission during index pregnancy from December 2016 to may 2018. The mothers and the babies were followed up till discharge. Maternal outcome was noted as discharged or died. The perinatal outcome was noted in terms of death, presence of congenital heart disease or other anomalies. Results: A total of 66 patients with cardiac disease among 16519 deliveries, were included in the study constituting the prevalence rate of 0.39%. Maximum number of the patients are in the age group between 20-24 year (65.8%). RHD (Rheumatic heart disease) being the commonest constituting 53.9 % (N=41). Among 41 RHD isolated MS (Mitral stenosis) found among 19 cases the dominant lesion. CHD (Congenital heart disease) being the second commonest found in 17 cases with VSD (Ventricular septal defect) being commonest. About 9 newborns had CHD detected in echocardiogram. 61.8% of the patients delivered vaginally. There were 5 maternal deaths due to cardiac disease. Conclusion: As RHD was common in rural population, and the need for penicillin prophylaxsis among them in adolescent girls. The facilities for cardiac surgery should be made available at affordable prices will definitely go a long way in reducing the mortality and morbidity related to cardiac disease. It is also necessary to follow up these patients in their future pregnancies.