Pregnancy Outcome for Pregnant Women with Common Cardiac Problems at Mansaura University Hospital

Document Type : Original Article

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Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Egypt

Abstract

Background : Pregnancy in the presence of heart disease (HD) poses a high risk of maternal mortality and morbidities including heart failure (HF), stroke and arrhythmias. The physiologic circulatory alterations related to pregnancy worsen the haemodynamic changes that are already present in these females. The fetus is also not spared as intrauterine growth restriction (IUGR) and prematurity also significantly increased.   
Aim : To assess maternal & fetal outcomes for pregnant women with common cardiac problem at Mansaura University hospital.  
Methods: This cross-sectional study included 90 pregnant females aged between 18 to 40 years with congenital heart disease (CHD), with rheumatic heart disease (RHD) who underwent elective abortion. The cases were followed up till delivery to determine the primary and secondary outcomes. The primary outcome was the rate of maternal complication as heart failure. The secondary outcome included changes in NYHA functional class, cardiovascular complications, post-partum complications, delivery mode and perinatal outcomes.  
Results: Rheumatic heart diseases were the most common in 81.1% while the non-rheumatic heart diseases were detected in 18. 9%. The history of previous abortion, the degree of mitral valve affection, the amount of intraoperative blood loss, the incidence of ICU admission and the incidence of puerperal pyrexia were statistically significantly higher in the non-rheumatic heart diseases (47.1%) as compared to the rheumatic heart diseases (30.1%). The mean ejection fraction, the 1- and 5- minutes APGAR scores, and the birth weight of the neonates were statistically significantly lower in the non-rheumatic heart diseases. 
Conclusion: We concluded that heart diseases in mothers are not absolute contraindications for pregnancy, but there were associated with serious outcomes on both the mothers and offsprings. The non-rheumatic heart diseases (mainly CHD) are associated with worse outcomes compared with the mothers with RHD.

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