STUDY OF MATERNAL AND FOETAL OUTCOME OF PREGNANCY COMPLICATED WITH HEART DISEASE AT A TERTIARY CARE CENTRE

Objectives: To analyse the type of heart disease complicating pregnancy, to study any associated obstetric or medical complications and their impact on pregnancy and heart disease, and to study the maternal and foetal outcome. Materials and methods: A retrospective analysis of 127 pregnant women with cardiac disease from January 2018 to December 2018 at Government Medical College and Hospital, Nagpur was done. Results: In the present study, incidence of cardiac disease is 1.09%. Rheumatic heart lesions (RHD) constituted 47% and congenital heart disease 41%. Mitral stenosis was the commonest lesion (26%), in RHD cases. While atrial septal defect (ASD) was seen in 12% cases. 69.4% of cases belong to New York Heart Association classification (NYHA) grade 1, 14.8% cases were NYHAgrade II, 14.2% cases were NYHAgrade III and 1.6% belong to NYHAgrade IV. Out of the total number of cases 7.08% cases were complicated by severe anaemia and 8.6% cases had PIH. Fifty three percent cases delivered vaginally & 40% by caesarean section. Ten cases were complicated with congestive cardiac failure, three had atrial fibrillation and two supraventricular tachycardia. 8.6% women developed pregnancy induced hypertension (PIH), 7.87% had intrauterine growth retdartion (IUGR), and 12.59% had preterm birth. There were three perinatal deaths and one maternal mortality. Conclusion: Heart disease in pregnancy is a high risk condition and has major impact on pregnancy. Early diagnosis by proper antenatal care and intervention could be the key to prevention of complications. Keywords: Cardiac disease; Pregnancy; NYHA grade