Cardiac diseases with pregnancy - A study of maternal and fetal outcome

Background: Total 0.2% to 4% of all pregnancies are complicated by cardiac diseases. In non western countries, rheumatic heart diseases (RHD) constitute 56-89% of the cases and congenital heart diseases only 9-19%. Aim and objectives: To review all obstetric patients with co-existing cardiac diseases admitted to a tertiary care center over a period of one year and ascertain the causes of admissions and the maternal and perinatal morbidity and mortality. Material and methods: A retrospective, analytical study of all patients with cardiac diseases who delivered over a period of January 2013 to December 2013 was conducted. A tabulated representation of the data was done. The various cardiac diseases were categorized according to their severity, NYHA category, type of pathology, the maternal and perinatal outcome was assessed and maternal mortality and perinatal mortality was recorded. Conclusion: Total 69% cardiac lesions in pregnancy were rheumatic in origin and 15% belonged to high risk category while 13.1% were NYHA type IV. Total 69% deliveries were by vaginal route. Epidural analgesia preferred in LSCS of cardiac patients. Perinatal and maternal complications were observed to increase with increase in NYHA class.