Dinesh, M R (2022) Maternal and Fetal Outcome in Heart Disease Complicating Pregnancy. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
In the Department of obstetrics and gynecology, Coimbatore Medical College and Hospital, Coimbatore during the study period from July 2020 to June 2021. ❖ 148 cases of heart disease complicating pregnancy were studied. ❖ The incidence of heart disease in pregnant patients is 1.43%. ❖ 65.8% were admitted from overcrowded areas. ❖ 87.83% of the patients with heart disease belonged to class IV and V socioeconomic status. ❖ 97.3% patients in the study group were booked cases. ❖ 56% of the patients were diagnosed to have heart disease during pregnancy and 44% were diagnosed before pregnancy. ❖ 87.82% of the patients were young and were less than 30 years of age. ❖ Only 1.8% of the study group were grand multigravida. ❖ 62% had rheumatic heart disease, 40% had congenital heart disease, 32% had mitral valve prolapse syndrome, 4% had primary pulmonary hypertension and 6% had cardiomyopathy. ❖ Isolated cases of mitral stenosis contributed to 14% of the cases and mitral stenosis was seen in combination with other valvular lesions in 20.01% of the patients. ❖ ASD is the most common congenital heart disease seen in the study group with an incidence of 40%. ❖ 21.62% patients had MVPS in the study group. ❖ 114 patients adopted some form of sterilisation out of which 45.60% underwent permanent sterilisation. Copper – T was inserted in 54.38% of the patients. ❖ The perinatal mortality in the study group was 2.85%. Maternal mortality was 2.7% in our study group. ❖ Among the rare heart diseases, 1. Primary Pulmonary Hypertension patients had 25% mortality. 2. Peripartum cardiomyopathy had 50% mortality. CONCLUSION: Heart disease in pregnancy continues to be the major cause of maternal mortality, preterm birth and perinatal mortality. Favourable outcome in pregnancies complicated by heart disease depends on the following factors: 1. Age, socioeconomic status. 2. Functional capacity of the heart and hemodynamic status of the patient. 3. Early Booking and comprehensive antenatal care 4. Comorbid conditions. 5. Quality of medical care. Early termination of pregnancy and prompt use of permanent sterilisation methods improve the survival of women with high risk cardiac disease. Once the pregnant patient seeks medical care, risk stratification is achieved and pregnancy can be continued in low risk group and the patients in high risk group are counselled for termination if necessary. Multidisciplinary approach with a team of obstetricians, cardiologist, anaesthetist, neonatologist combined with patient education provides the best opportunity to continue pregnancy with a good maternal and perinatal outcome. Maternal mortality in heart disease patients can be brought down significantly by effective preconceptional counselling, and improvements in medical, surgical, antenatal, intrapartum, and postnatal care and effective adaptation of contraception.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221916304 |
| Uncontrolled Keywords: | Maternal and Fetal Outcome, Heart Disease, Complicating Pregnancy. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology > MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Apr 2022 02:39 |
| Last Modified: | 08 Dec 2023 02:50 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19277 |
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