Heart Disease in Pregnancy: A Multi Disciplinary Approach
Creators
- 1. Assistant Professor, Department of Obstetrics & Gynaecology, Madurai Medical College, Madurai, Tamil Nadu, India
- 2. Assistant Professor, Department of Obstetrics & Gynaecology, Government Rajaji Hospital, Madurai, Tamil Nadu, India
- 3. Senior Resident, Department of Obstetrics & Gynaecology, Government Rajaji Hospital, Madurai, Tamil Nadu, India
- 4. Professor & Hod, Department of Obstetrics & Gynaecology, Government Rajaji Hospital, Madurai, Tamil Nadu, India
Description
Background: Cardiac Disease is an important cause of maternal morbidity and mortality both in antepartum and postpartum period. The overall incidence of heart disease in pregnancy is 2-4%. It can be congenital or acquired. In developing countries Rheumatic heart disease continues to be the major cause of morbidity and morbidity. Objective of present study was to determine the maternal outcome in pregnant women with heart disease and early intervention. Outcome of the study will highlight the effectiveness of cardiac intervention in appropriate patients and its outcome both maternal and fetal. Method: It is a prospective observational study. Conducted at Government Rajaji Hospital, Madurai for a period of 12 months from January 2020 to December 2020. Government Rajaji Hospital is a tertiary care referral centre, a Cemonc hospital where 216 pregnant woman with previously established or newly diagnosed during pregnancy were included in the study. They were registered and monitored from the time of registration and followed up till 12 months postpartum period. Results: Incidence of heart disease in our hospital is 1.3%. Among 216 mothers, 85.6% cases are of Rheumatic heart disease. Most of them belongs to mild moderate valvular lesion. Among 59 severe mitral stenotic heart disease, percutaneous mitral valve commissurotomy (PTMC) done for 11 cases. 11 of them delivered successfully without any adverse intrapartum and postpartum events. Overall mortality rate of heart disease complicating pregnancy in our institution is 0.4%.
Abstract (English)
Background: Cardiac Disease is an important cause of maternal morbidity and mortality both in antepartum and postpartum period. The overall incidence of heart disease in pregnancy is 2-4%. It can be congenital or acquired. In developing countries Rheumatic heart disease continues to be the major cause of morbidity and morbidity. Objective of present study was to determine the maternal outcome in pregnant women with heart disease and early intervention. Outcome of the study will highlight the effectiveness of cardiac intervention in appropriate patients and its outcome both maternal and fetal. Method: It is a prospective observational study. Conducted at Government Rajaji Hospital, Madurai for a period of 12 months from January 2020 to December 2020. Government Rajaji Hospital is a tertiary care referral centre, a Cemonc hospital where 216 pregnant woman with previously established or newly diagnosed during pregnancy were included in the study. They were registered and monitored from the time of registration and followed up till 12 months postpartum period. Results: Incidence of heart disease in our hospital is 1.3%. Among 216 mothers, 85.6% cases are of Rheumatic heart disease. Most of them belongs to mild moderate valvular lesion. Among 59 severe mitral stenotic heart disease, percutaneous mitral valve commissurotomy (PTMC) done for 11 cases. 11 of them delivered successfully without any adverse intrapartum and postpartum events. Overall mortality rate of heart disease complicating pregnancy in our institution is 0.4%.
Files
IJPCR,Vol15,Issue3,Article102.pdf
Files
(306.8 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:c2cd6fa2440dc504f66bb14c42ba28e7
|
306.8 kB | Preview Download |
Additional details
Dates
- Accepted
-
2023-03-13
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue3,Article102.pdf
- Development Status
- Active
References
- 1. Regitz- Zagrosek V, Blomstrom Lundqvist C, et al. ESC guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Disease during Pregnancy of the European Society of Cardiology (ESC), Eur Heart J. 2011: 32:3147-3197. 2. Silversides CK, Colman JM, Sermer M.Siu SC. Cardiac risk in pregnant women with rheumatic mitral stenosis, AM J Cardiol. 2003; 91: 1382- 1385. 3. Henriquez DD, Roos- Hesselink JW, Schalij MJ, etal. Treatment of valvular heart disease during pregnancy for improving maternal and neonatal outcome. Cochrane Database Syst. Rev. 2011 [CD008128]. 4. Mitral balloon valvuloplasty in pregnancy: advantages of a unique balloon. Gangbar EW1, Watson KR, Howard RJ, Chisholm RJ. 5. Precutaneous mitral balloon valvotomy in pregnancy using the Inoue balloon technique. 6. Balloon valvotomy for pregnant patients with severe pliable mitral stenosis using the Inoue technique with total abdominal and pelvic shielding. Ribeiro PA1, Fawzy ME, Awad M.Dunn B, Duran CG. 7. Percutancous mitral valvuloplastry during pregnancy: [Article in Spanish] Vitials F1, Olmos A, Sequel I, Gajardo J, Cuevas G. 8. Percutancous balloon mitral valvuloplasty in eight pregnant women with severe mitral stenosis. Ben Farhat M1, Maatouk F, Betbout F, Ayari M, Brahim H, Souissi M, Sghairi K, Gamar H. 9. Mitral valvuloplasty in pregnancy: a report of 4 cases, [Article in Italian] Ramondo A1, Barchitta A, Budano L, Lupia M, Chion R. 10. Balloon mitral valvuloplasty during pregnancy – our experience. [Article in English, Portuguese] 11. Mishra S., Narang R., Sharma M. Percutaneous transseptal mitral commissurotomy in pregnant women with critical mitral stenosis. Indian Heart J. 2001;53:192–196. 12. Singh Y., Manjunath C., Nanjappa Immediate and intermediate-term outcomes of percutaneous transvenous mitral commissurotomy during pregnancy: our experience with accura balloon at a high-volume center. Indian Heart J. 2013;65:S33–S93.13. 13. Harikrishnan S., Srinivasan A., Sivasubramoniam S. Long-term outcome of patients undergoing balloon mitral valvotomy in pregnancy. Am J Cardiol. 2005;95 :15 04–1506. 14. Gupta A., Lokhandwala Y.Y., Satoskar P.R., Salvi V.S. Balloon mitral valvotomy in pregnancy: maternal and fetal outcomes. Am Coll Surg. 1998; 187(October (4)):409–415. 15. Routray S.N., Mishra T.K., Swain S., Patnaik U.K., Behera M. Balloon mitral valvuloplasty during pregnancy. Int J Gynaecol Obstet. 2004;85(April (1)):18–23. 16. Kinsara A.J., Ismail O., Fawzi M.E. Effect of balloon mitral valvuloplasty during pregnancy on childhood development. Cardiology. 2002;97 (3): 155–158.