Maternal and Fetal Outcome in Pregnant Women with Cardiac Disease
Author(s): Bhavana Kakaria, Ashish K
The objective of the study was to compare and evaluate the pregnancy and fetal outcome of women with cardiac disease, with low risk pregnant women. A retrospective comparative analysis of maternal and fetal outcomes of 34 pregnant women with cardiac disease, with 34 low risk pregnant women who delivered during the same period (June 2015– May 2016) was performed. Low risk women had their hospital identity numbers sealed in an envelope and lots were drawn to pick the numbers to prevent selection bias. Descriptive statistical analysis was used. Women with cardiac disease had a high incidence of cardiac surgical intervention, higher rates of instrumental deliveries (41.16% Vs 8.82%), cesarean deliveries (26.46% Vs 23.52%) and higher morbidity (52.92% Vs 5.88%). Although there was an equal rates of pre-term delivery (5.88% Vs 5.88%), low birth weight (2667.50 +/- 250 Gms Vs 2833.52 +/- 350 Gms), but a higher incidence of APGAR scores < 8 (49.98% Vs 41.16%) was encountered in the subject group. Women with previously detected heart disease and who had late booking during the present pregnancy had more antepartum, intrapartum and post partum complications 50% vs 35.72% and increase transfer of neonate to nursery, though not statistically significant. Women with cardiac procedures done previously had less complications antepartum, intrapartum, and in the postpartum period and less occurrence of intrauterine growth retardation, compared to women who were not operated previously; 01 (12.50%) vs10 (38.46%), p value-<0.05. and 01 (12.50%) vs 08 (30.76%), p value-<0.05 respectively. Multispecialty approach is required for optimal management and a better outcome in pregnant women with cardiac disease. Pre pregnancy major surgical interventions in the form of balloon mitral valvotomy, closed mitral valvotomy, mitral valve replacement should be performed before pregnancy to prevent maternal complications and to achieve optimum fetal outcome.