Maternal and perinatal outcome in rheumatic heart disease
Sawhney, H.; Aggarwal, N.; Suri, V.; Vasishta, K.; Sharma, Y.; Grover, A.
International Journal of Gynaecology and Obstetrics the Official Organ of the International Federation of Gynaecology and Obstetrics 80(1): 9-14
2003
ISSN/ISBN: 0020-7292 PMID: 12527454 DOI: 10.1016/s0020-7292(02)00029-2Document Number: 245570
To study the maternal and perinatal outcome of pregnancies complicated by rheumatic heart disease. A retrospective study was carried out in the cardio-obstetric clinic of the Postgraduate Institute of Medical Education and Research, Chandigarh (India) over a period of 13 years (1987-1999) involving 486 pregnant patients with rheumatic heart disease. Maternal and perinatal outcome was reviewed. Three hundred and four patients (63.3%) had single valve involvement and mitral stenosis was the most predominant lesion (89.2%). One hundred and seventy one (38.6%) patients had undergone surgical correction prior to the onset of pregnancy. One hundred and thirteen patients (22.6%) were identified as NYHA class III-IV. Mitral valvotomy was performed during pregnancy in 48 patients. The incidence of preterm birth and small for gestational age newborns was 12% and 18.2%, respectively. There were 10 maternal deaths, of which eight patients were NYHA III and IV. Rheumatic heart disease in pregnancy is associated with significant maternal and perinatal morbidity in NYHA class III-IV patients.