[Retrospective epidemiological study of pregnancy complicated by heart disease during 15 years in Shanghai]

To investigate the changes of pregnancy complicated by heart disease.

Clinical data of hospitalized pregnant women with heart disease, collected from 10 teaching hospitals in Shanghai during 1981-1995, were analysed retrospectively.

2,680 of 379,065 deliveries (0.71%) were complicated by heart disease during that period. There were a total of 121 maternal deaths, 15 of them due to heart disease, the mortality of heart disease was 0.56%, and the percentage in total maternal deaths was 12.40%. The incidence and mortality rates were similar in 1981-1985, 1986-1990, 1991-1995, but the percentage due to heart disease increased after the late 1980s. The rates of congenital heart disease increased and rhumatic heart disease decreased apparently, the ratio of the former to the latter was 1.76:1. The pregnancy induced hypertension heart disease, the peripartum cardiomyopathy and the miscellaneous heart disease all increased obviously during the 1990s. The heart functions of grade I and II accounted for a considerable proportion (85.45%), but the grade IV tended to increase during the 1990s. Heart failure occurred in 172 cases, with an incidence of 7.6%. The perinatal mortality rate was 7.76%. Cesarean sections were often performed in heart disease women.

Pregnancy complicated by heart disease is still one of the major cause of maternal deaths up till now. More effective management should be adopted.