Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2018 | Month : July | Volume : 12 | Issue : 7 | Page : QC16 - QC20

The Spectrum of Heart Disease in Pregnancy and its Outcome in Patients Visiting a Tertiary Care Centre of Northeastern: A Prospective Study

Dina Aisha Khan, Nalini Sharma, Manish Kapoor, Sourabh Gohain Duwarah, Santa Singh Ahanthem

1. Postgraduate Trainee, Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. 2. Assistant Professor, Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. 3. Associate Professor, Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. 4. Head, Paediatric Ayursundra Superspeciality Hospital, Guwahati, Assam, India. 5. Professor and Head, Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Correspondence Address :
Dr. Nalini Sharma,
B-1 D, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong-793018, Meghalaya, India.
E-mail: Nalinisharma100@rediffmail.com

Abstract

Introduction: An increased prevalence of cardiovascular disease has been found in women of child bearing age which varies between 0.3-3.5%. Heart diseases are the most significant non obstetrical causes of maternal deaths accounting for as much as 20.5% of all cases. Heart disease in pregnancy is a high risk condition with increased risk of maternal and foetal morbidity and mortality; hence it mandates a multidisciplinary approach.

Aim: To find out prevalence, spectrum of disorder and outcome in pregnancy with heart disease in a tertiary care centre in North Eastern India.

Materials and Methods: In this prospective hospital based, time bound study all pregnant women or puerperia with heart disease during the study period were followed up throughout pregnancy and their feto-maternal outcomes were compared with equal number of women without heart disease. Based on the symptoms all the patients were classified according to New York Heart Association (NYHA) functional classification. Patients were evaluated for development of any cardiac complication, obstetrical complication, and perinatal outcomes. Statistical analysis was performed using the SPSS software package (version 16.0).

Results: Total number of pregnant women with heart disease was 55 and prevalence of heart disease in pregnant women admitted during the study period was found to be 2.32%. Congenital heart disease was the most common encountered type 49.09% followed by Rheumatic Heart Disease (RHD) 41.82%. Cardiac complications were present in 18% women and most common complication was congestive cardiac failure (80%). Preterm delivery was significantly higher among the cases (25%). Instrumental deliveries were higher among the cases (23.06% vs. 7.6%). The foetal outcome (live birth) was significantly better in controls. Low birth weight was higher among the cases (34.61% babies among cases and 12.73% babies among controls). Out of all maternal deaths, 10.34% were attributed to cardiac cause. All three mothers who died belonged to NYHA Class 4 and were anaemic.

Conclusion: There is a significant shift in trends of spectrum of heart disease with congenital emerging as predominant lesion. This signifies an important change in the trends and spectrum of cardiac disease in our institute with lower incidence of RHD. With better health facilities, pregnant women with congenital heart disease will continue to rise and hence expertise in management of such conditions is imperative in times to come.

Keywords

Congenital heart disease, Maternal morbidity, Maternal mortality, Perinatal outcome, Rheumatic heart disease

How to cite this article :

Dina Aisha Khan, Nalini Sharma, Manish Kapoor, Sourabh Gohain Duwarah, Santa Singh Ahanthem. THE SPECTRUM OF HEART DISEASE IN PREGNANCY AND ITS OUTCOME IN PATIENTS VISITING A TERTIARY CARE CENTRE OF NORTHEASTERN: A PROSPECTIVE STUDY. Journal of Clinical and Diagnostic Research [serial online] 2018 July [cited: 2018 Jul 16 ]; 12:QC16-QC20. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2018&month=July&volume=12&issue=7&page=QC16-QC20&id=11837

DOI and Others

DOI: 10.7860/JCDR/2018/35407.11837

Date of Submission: Jan 10, 2018
Date of Peer Review: Mar 07, 2018
Date of Acceptance: Apr 02, 2018
Date of Publishing: Jul 01, 2018

FINANCIAL OR OTHER COMPETING INTERESTS: None.

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