Farhana Asghar, Hina Kokab.
Evaluation and outcome of Pregnancy complicated by heart disease
J Pak Med Assoc Oct 2005;55(10):416-9.
Nishtar Hospital, Multan
Objective: To assess the maternal and fetal outcome in pregnancies associated with maternal heart disease. Methods: The study included 50 pregnant cardiac patients from the Department of Obstetrics and Gynecology Unit-I Nishtar Hospital, Multan. Age, parity, type of cardiac lesions, class of disease, specific treatment given, obstetric and cardiac complications, maternal and fetal outcome were analyzed. Results: Out of 5100 obstetric patients, 50 cases of heart disease were diagnosed, giving a frequency of 0.98%. The ages of the women ranged between 26-35 years (64%) and 52% were multigravida. Congenital Heart Disease (CHD) was present in 28% cases and 66% had Rheumatic Heart Disease (RHD) and mitral stenosis which was the dominant lesion. Anticoagulation was given to 3 (6%) cases, Digoxin was required in 20 (40%) cases, Diuretics 18 (36%) while antihypertensive and beta blockers were given to 4 (8%) cases each, whereas prophylactic antibiotic was given to all (100%) patients. Congestive Cardiac Failure (CCF) was seen in 10 (20%) cases, infective endocarditis and thromboembolism in one (2%) case each. Maternal mortality occurred in one (2%) case and one (2%) neonatal death was encountered. Cardiomyopathy was seen in 2 (4%) cases. Vaginal delivery was had in 91.49% women and 80% were term pregnancies. Preterm deliveries were 14% and 42.55% babies were of low birth weight. Conclusion: Although, heart disease is rare among pregnant women, it needs to be carefully managed in a tertiary care setting by a team of obstetrician, cardiologist and anaesthesiologist, to obtain good maternal and foetal outcome (JPMA 55:416;2005).
Category: Obstetrics and Gynecology
Keywords: Pregnancy. Cardiomyopathy.
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