Pregnancies Complicated by Maternal Heart Diseases

Objective : To assess the pregnancy outcomes complicated by maternal heart diseases. Methods : From 1994 to 2001, medical records of pregnant women who had reached at least 20 weeks of gestation with maternal heart diseases were reviewed. Results : 224 deliveries of 195 women were enrolled in this study. In 117 (52.2%) cases the heart diseases were of rheumatic origin, in 96 (42.9%) cases congenital, and the remaining 11 (4.9%) cases were miscellaneous group that included arrhythmia, cardiomyopathy, and mitral valve prolapse. There were 2 (0.9%) cases of maternal death related to pregnancy. Majority (91.9%) were in New York Heart Association functional classes I, II before, during, and after delivery. Mean gestational age at birth and birth weight were 37.9 weeks and 2883 gm. Perinatal mortality rate was 17.9/1000 and the rate of congenital malformation was 2.7%. Recurrence risk of neonatal congenital heart disease was 2.1%. Conclusion : Most complications were developed in the pregnancies complicated by maternal heart diseases with New York Heart Association functional classes III, IV. Functional status of the pregnant women is the important risk factor in maternal and fetal outcomes.