AbstractIntroduction: Heart disease during pregnancy increases maternal morbidity and mortality, it should be managed very meticulously by team of experts from various specialties viz. obstetricians, cardiologists and cardiovascular surgeons, anaesthetist, and neonatologist. The evaluation of patients with cardiovascular disease should ideally begin prior to conception so that appropriate evaluations can be made without putting the foetus or mother at risk. Aims and objectives: 1) To study the foetal outcome and perinatal mortality in patients of pregnancy with heart disease. 2)To study the maternal mortality in patients of pregnancy with heart disease. Materials and Method: In the present prospective study all the cases of heart disease in pregnancy admitted in obstetrics and gynaecology department of Dr. V.M.G.H. Solapur during the study period were enrolled. All the selected patients underwent detailed antenatal evaluation. Detailed medical history along with routine obstetric history was elicited regarding duration of disease, medication. All the enrolled cases were followed up to the delivery. All these cases were analyzed with regard to their age, type of cardiac lesion, NYHA status and mode of delivery, obstetric and medical complication, and maternal death if any. Foetal outcome was recorded by parameters namely gestational age (term or preterm), birth weight, admission to neonatal intensive care unit (NICU), and neonatal death if any. Results: Majority of the patients were in the age group of 2029yrs. Rheumatic heart disease was the most common heart disease with NYHA Class I. Spontaneous vaginal delivery was conducted in 70% (n=21) cases. Ventouse was applied to cut short second stage of labour in 3.3% (n=1) cases. Caesarean section was done in 26.6% (n=8) cases, of which 3.3% (n=1) were elective and 23.3% (n=7) were emergency. Out of total 30 live birth babies, 43.3% (n=13) babies were low birth weight and 56.7% (n=17) were having birth weight 2.5 kg. Among 30 babies, 23.3% (n= 7) were admitted to NICU. Perinatal mortality was 64.5 per 1000 live births in pregnancy with heart disease. There were no maternal deaths among enrolled pregnant patients with heart disease during study period. Conclusion: Thus we conclude that the most common mode of delivery among the pregnant women with heart disease was spontaneous vaginal delivery followed by emergency caesarean section with foetal distress as the common indication. For NICU admission foetal distress, mothers in intensive care unit and IUGR were the common indication. The perinatal mortality was 64.5 per 1000 live births in pregnancy with heart disease where as no maternal deaths among the study patients noted.
Key words: Heart Disease in Pregnancy; Outcome; Perinatal Mortality Rate.