Document Detail


Cardiac disease in pregnancy.
MedLine Citation:
PMID:  12873775     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the maternal and fetal outcome of pregnancies complicated by cardiac disease in a developing country. METHODS: A retrospective analysis was carried out of 207 pregnancies in women with cardiac disease who delivered at >or=28 weeks of gestation from June 1994 through December 2000 at a tertiary care center. RESULTS: Rheumatic heart disease (n=183, 88%) with isolated mitral stenosis (n=71) was the predominant cardiac problem. Septal defects were the most common form of congenital heart disease (n=24). In 28 (13.52%) women, the diagnosis of cardiac disease was made during pregnancy. Cardiac complications were noted in 62 (29.95%) and fetal complications in 42 (20.28%) pregnancies. Patients in NYHA class I/II (n=175, 84.54%) had fewer maternal complications and their babies had a higher birth weight than those in NYHA class III/IV (n=32, 15.45%). Cardiac intervention was performed prior to pregnancy in 111 (60.65%) patients with rheumatic heart disease: PTMC/CMV in 73 and valve replacement (VR) in 38. Maternal and fetal outcome was better in patients with prosthetic valves (n=38) and the majority (97.4%) of them remained in NYHA class I/II. Cardiac intervention was safely carried out during pregnancy in 10 women (PTMC in 7, CMV in l, and VR in 2). One of them developed congestive cardiac failure during labor. None of the newborns of the 41 women who had received anticoagulants had any congenital malformation. CONCLUSIONS: Rheumatic heart disease was the predominant type. Patients in NYHA class I/II had a better maternal and fetal outcome than those in NYHA class III/IV. Surgical correction of the cardiac lesion prior to pregnancy was associated with better pregnancy outcome. Pregnant women with prosthetic valves tolerated pregnancy well.
Authors:
N Bhatla; S Lal; G Behera; A Kriplani; S Mittal; N Agarwal; K K Talwar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  82     ISSN:  0020-7292     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-07-22     Completed Date:  2003-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  153-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India. neerjabhatla@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiovascular Agents / therapeutic use
Female
Heart Defects, Congenital / therapy
Heart Diseases / diagnosis,  drug therapy,  epidemiology,  surgery,  therapy*
Heart Valve Prosthesis
Humans
India / epidemiology
Infant, Low Birth Weight
Infant, Newborn
Labor, Obstetric
Pregnancy
Pregnancy Complications, Cardiovascular / diagnosis,  drug therapy,  epidemiology,  surgery,  therapy*
Pregnancy Outcome
Pregnancy, High-Risk*
Retrospective Studies
Rheumatic Heart Disease / therapy
Risk Assessment
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Cardiovascular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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