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Cardiac disease in pregnancy
1Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India. neerjabhatla@hotmail.com
Summary
Pregnancies with heart disease in developing countries show better outcomes when managed before or during pregnancy. Rheumatic heart disease is common, and early intervention improves maternal and fetal health.
Area of Science:
- Cardiology
- Obstetrics
- Maternal-Fetal Medicine
Background:
- Cardiac disease complicates pregnancies, posing risks to both mother and fetus.
- Developing countries face unique challenges in managing these high-risk pregnancies.
Purpose of the Study:
- To evaluate maternal and fetal outcomes in pregnancies affected by cardiac disease.
- To identify factors influencing pregnancy outcomes in this population within a developing country context.
Main Methods:
- Retrospective analysis of 207 pregnancies in women with cardiac disease delivering at a tertiary care center.
- Data collected from June 1994 to December 2000, including cardiac diagnoses, complications, and interventions.
Main Results:
- Rheumatic heart disease was the most prevalent condition (88%), followed by congenital heart defects.
- Cardiac complications occurred in 29.95% and fetal complications in 20.28% of pregnancies.
- Patients in New York Heart Association (NYHA) class I/II experienced better maternal and fetal outcomes compared to NYHA class III/IV.
Conclusions:
- Rheumatic heart disease is the leading cardiac issue in pregnant women in this setting.
- Early surgical correction of cardiac lesions before pregnancy is associated with improved outcomes.
- Pregnant women with prosthetic valves generally tolerate pregnancy well, with good maternal and fetal results.