The New Indian Journal of OBGYN. 12(1):174-178

Maternal and cardiac outcome in surgically intervened cardiac disease complicating pregnancy: a cross sectional study from a tertiary care centre in South India

Briji S Panicker, Sheila Balakrishnan

ABSTRACT

Objectives: To compare the cardiac and obstetric outcomes in patients with pregnancies complicated with surgically intervened cardiac disease and compare with outcomes in normal patients. To suggest modifications in care, if any, of patients who had previously undergone cardiac surgery in order to improve outcomes for the mothers. Methods: This was a cross sectional study involving 81 patients who had previously undergone cardiac surgery and admitted to the labour room of Sri Avittam Thirunal (SAT) hospital, Medical College, Thiruvananthapuram between July 2007 and December 2008. They were compared with equal numbers of patients with low risk normal pregnancies. Results: Among the 81 cardiac patients, 51 patients had congenital heart disease (CHD) and 30 patients had acquired valvular heart disease (AVHD). All the AVHD were rheumatic in origin. All the patients who had undergone cardiac surgery during pregnancy had improvement of cardiac status from New York Heart Association (NYHA) Class III, Class IV to Class II. Among the patients in low risk group (Class I & II), majority (44.60%) had spontaneous vaginal delivery and among the patients in high risk group (Class III & IV), 57.1% had outlet forceps delivery. In low risk group, majority (97.3%) had no postpartum complications. In high risk group 57.1% patients had pulmonary oedema. Conclusion: Cardiac patients with better functional class have the best cardiac outcomes. Most of the patients who had surgical correction were in the higher functional class and had little or no deterioration in their cardiac status.