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Indian Journal of Maternal-Fetal & Neonatal Medicine

Volume  4, Issue 2, Jul-Dec 2017, Pages 159-164
 

Original Article

A Study of Heart Disease in Pregnancy and the Associated Complications

Pallavi Y. Untwal1, Mangala A. Shinde2

1Speciality Medical Officer, Dept. of OBGY, Lokmanya Tilak Municipal Medical College and Hospital Sion, Mumbai, Maharashtra 400022, India 2Professor and HOD, Dept. of OBGY, Government Medical College, Latur, Maharashtra 413512, India.

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DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.4217.10

Abstract

Introduction: Pregnancy associated with any medical illness becomes a challenge for an obstetrician. Cardiac disease is one such medical illness which complicates 0.1 – 4% of pregnancies. Aims and objectives: 1) to study incidence of heart disease associated with pregnancy at a Dr.V.M.G.H. Solapur. 2)To study the baseline characteristics of patients and associated complications of heart disease in pregnancy. Materials and Method: In the present cross sectional study all the cases of heart disease in pregnancy admitted in obstetrics and gynaecology department of Dr. V.M.G.H. Solapur during the study period were enrolled. All the selected patients underwent detailed antenatal evaluation. Detailed medical history along with routine obstetric history was elicited regarding duration of disease, medication. All these cases were analyzed with regard to their age, education, socioeconomic class, locality (urban or rural), parity, type of cardiac lesion, NYHA status. Results: Out of total 16362 deliveries; 39 pregnant patients were diagnosed with heart disease. Thus the incidence of heart disease in pregnant patients in the study was 0.24%. The mean age of patients, was 24.6 ± 5.2 years. 89.7% belonged to lower socioeconomic class. Rheumatic heart disease was the most common heart disease (74.4%) followed by Congenital heart disease was found in 20.5%. In 38.46% patients heart disease was diagnosed during the present pregnancy, whereas in 61.54% patients heart disease was diagnosed in previous pregnancy or before. Dyspnoea (61.5%) was the most common presenting complaint followed by palpitation (23.1%). 66.7% patients were from NYHA Class I, followed by 23.1% from NYHA Class II. Pulmonary hypertension was seen in 17.9% cases. Congestive heart failure was developed in 7.7% cases. Anaemia was noted in 10.3% cases, whereas Hypertensive disorders of pregnancy (12.8%), postpartum haemorrhage (5.1%), Oligohydramnios 2.6% (n = 1) were predominant obstetrical complications. Conclusion: Thus we conclude that the incidence of heart disease in pregnant patients in the study was 0.24%. Rheumatic heart disease was the predominant cause of heart disease in pregnancy and was seen mainly in the age group of 2029 years of age among the lower socioeconomic class women. Dyspnoea and palpitations were the most common presenting symptoms with NYHA class I. Pulmonary hypertension and congestive heart failure were the common cardiac and noncardiac hypertensive disorders of pregnancy and anaemia were common non cardiac complications.

Keywords: Pregnancy; Heart Disease; Symptoms; Complications. 


Corresponding Author : Pallavi Y. Untwal Speciality Medical Officer, Dept. of OBGY, Lokmanya Tilak Municipal Medical College and Hospital Sion, Mumbai, Maharashtra 400022, India.