Cardiac diseases in pregnancy: clinical profile and feto-maternal complications

Background: Pregnancy in woman with heart disease increases the risk of maternal and fetal complications. About 1% of pregnant women have concomitant cardiac disease. The present research was conducted to study the profile of cardiac diseases in pregnancy and its associated complications.Methods: A prospective analysis was carried out of 55 pregnancies of women with cardiac disease from at a tertiary care center. Standard Ante-natal care was furnished to all patients subjective to their requirements. Condition of patient during labour as well as the progress of labour was closely monitored. Fetal and maternal outcome after delivery as well as development of any complication was noted and treated accordingly. Data was analyzed using SPSS software ver. 21.0.Results: In present study, RHD constituted 71% cases while CHD constitutes 11% of all cases of heart disease. Other etiologies were dilated cardiomyopathies (DCM) (12.7%), IHD (3.6%) and arrhythmias (18%). Most common anomaly associated with RHD cases was mitral stenosis (75%) either isolated or along with other valvular pathologies. Most common CHD was atrial septal defect seen in 4 out of 6 cases. A total of 8 patients (16%) developed complications of which, 4 had postpartum hemorrhage, 2 developed pulmonary oedema, 1 had arrhythmia and 1 patient developed septic shock and multi organ failure. A total of 74% babies were healthy while IUGR and intrauterine deaths were seen in 22% cases and 4% cases respectively.Conclusions: Rheumatic heart disease is the predominant type of cardiac disease in pregnancy. Maternal and perinatal outcome can be improved by team approach at tertiary care center. Counselling for contraception and family planning and follow up during subsequent pregnancies is mandatory