Maternal and fetal outcomes among pregnant women with cardiac disease attending a tertiary care hospital: A prospective observational study

Abstract

BACKGROUND: Pregnancy in women with cardiac disease is associated with an increased risk for adverse maternal and neonatal outcomes and the present study evaluated maternal and fetal outcomes of pregnancies complicated by cardiac disease. MATERIALS AND METHODS: An observational prospective study was conducted among 105 pregnant women with cardiac disease attending a tertiary care hospital from February 1, 2017, to January 31, 2018, and followed 30 days postpartum. Data on maternal and gestational age, nature of the underlying cardiac lesion, comorbidities, cardiac intervention, and medication were recorded. Up until 28 weeks, the patients were checked every 2 weeks by an obstetrician and a cardiologist, then weekly until birth. Age groups, cardiac lesion, and maternal and fetal outcomes were presented as frequency, and proportion was analyzed using coGuide software, V.1.0 was used for statistical analysis BDSS, Bangalore, Karnataka, India. RESULTS: Out of 101 subjects, 98 (97.03%) were aged 18–35 years, 75 (74.3%) participants had K/C/O cardiac disease, and in 24 (23.8%) subjects, rheumatic heart disease with isolated mitral stenosis was the predominant cardiac problem. Twenty-two (21%) subjects had undergone surgical correction before to pregnancy, and 6 (8%) patients had cardiac complications, among which 1 (2.9%) had pulmonary edema. Maternal death was noted in 4 patients (3.6%). The incidence of cases with small for gestational age was noted in 36 (35.6%) patients, fresh stillbirth in 1 (2.9%), macerated stillbirth in 1 (2.9%), and neonatal death was noted in 1 (2.9%) patients. Twenty-six (25.7%) participants were diagnosed for the first time with cardiac disease. CONCLUSIONS: Heart disease is linked to an increased risk of severe maternal and perinatal outcomes, such as maternal and fetal death and morbidity, among pregnant women.