晚期妊娠分娩前休克37例处理及围生期结局

目的:探讨晚期妊娠分娩前发生休克患者的积极治疗方法以改善围生期母耍的结局.方法:对2000年1月至2008年6月在我院产科分娩的、资料齐全的37例晚期妊娠分娩前发生休克患者的临床资料进行回顾性分析.结果:晚期妊娠分娩前发生休克以低血容量性休克为主,占62.2%(23/37),除1例外,休克或入院至胎儿娩出的平均时间55.6分钟.终止妊娠的方式,剖宫产占86.5%(32/37),阴道分娩占13.5%(5/37).共分娩39个新生儿,其中早产儿51.3%(20/39)、围生儿死亡率12.8%(5/39).行子宫切除3例.发生多器官功能障碍综合征(MODS)3例,无孕产妇死亡.结论:晚期妊娠分娩前发生休克,通过及时诊断、积极抗休克治疗,适时终止妊娠,大多数患者可以取得良好的围生期结局.     

孕产妇合并甲型H1N1流感对母儿结局的影响

目的 探讨孕产妇合并甲型H1N1流感(简称甲流)对母儿结局的影响及产科处理.方法 收集2009年11月7日至2009年12月15日中国医科大学附属盛京医院收治的19例合并甲流的孕产妇资料,回顾性分析甲流对母儿的影响. 结果 19例患者中,产褥期妇女3例,占15.8%,均为轻症,愈后良好.孕期患者16例,占84.2%,其中早期妊娠2例(12.5%),中期妊娠7例(43.8%),晚期妊娠7例(43.8%).16例孕期患者按病情严重程度分,轻症6例(37.5%),重症2例(12.5%),危重症8例(50.0%).2例早期妊娠患者均为轻症,甲流治愈后选择人工流产;中期妊娠的4例轻症患者甲流治愈后足月分娩,3例重症及危重症患者中1例甲流治愈后足月分娩,1例孕27周胎死宫内和1例孕23周因孕妇发生严重并发症,均行剖宫取胎术,后者胎儿娩出后死亡;妊娠晚期的7例均为重症及危重症患者,均行急诊剖宫产术终止妊娠,2例胎儿孕晚期胎死宫内,余5例存活,包括4例早产儿和1例足月儿.行急诊剖宫产手术的全部9例(56.3%,9/16)重症及危重症孕妇中,活产新生儿6例,存活的5例均未感染甲流;2例孕产妇术后死亡(10.5%,2/19). 结论妊娠晚期孕妇感染甲流极易发展为重症及危重症,及时终止妊娠是挽救母儿生命又使新生儿避免甲流病毒感染的有效方法之一.     

妊娠合并干燥综合征患者母儿结局及相关因素分析

目的探讨妊娠合并原发性干燥综合征患者母儿结局及相关因素。方法选取2008年1月至2020年5月间就诊于北京大学人民医院产科的原发性干燥综合征患者52例为研究组;随机选取同期在本院建档的单胎妊娠260例作为正常对照组。研究组按照诊断时间分为孕前诊断组和孕期诊断组。结果 52例患者共56次妊娠,无孕产妇死亡,共获得活产新生儿55例(98.2%),胎死宫内1例次(1.8%)。分娩孕周(38.15±1.90),阴道分娩例27例(48.2%),剖宫产29例(51.8%)。研究组与对照组平均年龄[(31.89±3.55)vs(30.81±3.73)]岁,P=0.035;平均分娩孕周[(38.15±1.90) vs (39.36±1.23)]周,P 0.001;新生儿平均体重[(2 985.27±515.90)vs(3 372.54±431.87)]g,P 0.001;早产(16.1%vs 3.8%,P=0.002);子痫前期(5.4%vs 0.8%,P=0.041)、剖宫产率(51.8%vs 22.7%,P 0.001)均低于对照组,差异有统计学意义(P 0.05)。孕期诊断组较孕前诊断组分娩孕周低[(36.26±2.76)vs (38.34±1.73)]周,P=0.018),子痫前期的发生率高(33.3%vs 2%,P=0.028),差异有统计学意义(P 0.05)。结论妊娠合并原发性干燥综合征患者妊娠并发症高,早产、子痫前期发生率增加。     

孕妇泌尿道感染与死胎

为探讨孕妇泌尿道感染与临产胎儿和新生儿死亡关系,作者在8年中,通过美国12所医院,检查观察了53,518例孕妇,结果发现在患有羊水增多、羊水感染及Rh疾病等8种疾病的孕妇而又合并脓尿及菌尿的泌尿道感染者的胎儿死亡率高达42‰;不合并菌尿及脓尿者的胎儿死亡率仅有21‰,两者有显著差异(P<0.001)。文中菌尿标准为每毫升尿液中菌数大于100,000个细菌(杜氏杆菌及乳酸杆菌不计在内),脓尿则指在导尿或中断尿中经显微镜常规检验,在每高倍视野下白细胞数超过15个以上。并以在临产前15天内发生泌尿道感染的孕     

妊娠早期胎儿颈部透明层厚度与胎儿预后的前瞻性队列研究

目的探讨妊娠早期胎儿颈部透明层(NT)厚度与胎儿预后的关系。方法收集2015年12月至2018年12月于南京大学医学院附属鼓楼医院行妊娠早期胎儿NT厚度测量的单胎孕妇,共4958例建立前瞻性研究队列,进行妊娠早期胎儿结构超声筛查、妊娠早期血清学筛查、妊娠中期超声筛查及对新生儿出生后28 d的体格检查。根据妊娠早期超声筛查的结果,分为胎儿NT增厚(≥3.0 mm)者167例与NT厚度正常者4791例;将胎儿NT增厚的孕妇,分为胎儿单纯NT增厚者86例与NT增厚合并结构异常者81例。分析不同NT厚度胎儿的预后,并重点对单纯NT增厚与NT增厚合并结构异常胎儿的妊娠结局进行分析。妊娠早期超声筛查发现胎儿结构异常或血清学筛查结果为高风险的孕妇,经绒毛穿刺取样术行染色体微阵列分析(CMA)检测以明确产前诊断。结果(1)胎儿NT厚度正常孕妇的妊娠结局:共4791例孕妇,包括胎儿NT厚度正常且无结构异常者4726例,其中妊娠中期及产后新诊断结构异常83例,4688例活产;胎儿NT厚度正常但结构异常的孕妇65例,其中61例孕妇终止妊娠,4例活产。(2)胎儿单纯NT增厚孕妇的妊娠结局:86例孕妇中,66例(76.7%,66/86)行CMA检测,3例胎儿诊断为21三体综合征;除7例孕妇选择终止妊娠外,余79例行妊娠中期超声检查、新生儿出生后28 d体格检查、新生儿电话随访至6~21个月均未发现发育异常。(3)胎儿NT增厚合并结构异常孕妇的妊娠结局:81例孕妇中,73例(90.1%,73/81)行CMA检测,其中32例的胎儿为染色体非整倍体异常。70例选择终止妊娠,2例妊娠中期自然流产,9例活产。(4)NT增厚是否合并结构异常胎儿的产前诊断结果及预后比较:单纯NT增厚的胎儿染色体非整倍体的发生率为3.5%(3/86),合并结构异常者为39.5%(32/81),两者比较,差异有统计学意义(χ2=32.7,P<0.01);胎儿单纯NT增厚孕妇的健康新生儿存活率为91.9%(79/86),合并结构异常者为9.9%(8/81),两者比较,差异有统计学意义(χ2=112.3,P<0.01)。结论妊娠早期,超声筛查胎儿NT及结构,能提高出生缺陷的产前筛查率。单纯NT增厚胎儿的染色体非整倍体的发生率较低,新生儿健康存活率较高。     

孕期生殖道感染对妊娠结局的不良影响

目的探讨孕期生殖道感染(RTI)对妊娠结局造成的不良影响。方法选择2010年4月~2014年4月来我院妇产科定期接受产检并分娩的孕妇50例作为研究对象,根据其是否存在孕期生殖感染分为实验组21例和对照组29例,并对两组妊娠结果进行分析和比较。结果实验组早破、早产、低出生体重、新生儿畸形及出现死胎的几率分别为15.65%、12.5%、6.05%、3.72%、13.26%;对照组为9.37%、5.42%、2.03%、0.5%、5.04%。两组比较差异有统计学意义(P0.05)。结论孕期生殖道感染将会对妊娠结局造成一定的负面影响,在临床工作中医护人员要对孕妇是否存在生殖道感染加以重视,并且做好系统的筛查检测、治疗以及护理工作。     

孕产妇围生期感染易感因素及其对妊娠结局和新生儿免疫功能的影响

目的 探究孕产妇围生期感染易感因素及其对妊娠结局和新生儿免疫功能的影响.方法 选取围生期感染孕产妇(116例)为研究对象,并纳入同期无围产期感染孕产妇(75例)作对照组,分析孕产妇围生期感染的危险因素,比较两组妊娠结局和新生儿免疫功能水平.结果 定期孕期产检是发生围生期感染的独立保护因素,侵入性操作和住院时间(≥7d)...     

妊娠期生殖道感染对妊娠结局的影响

目的 探讨妊娠期生殖道感染对妊娠结局的影响。方法 选取本院收治的100例妊娠期生殖道感染孕妇为感染组,同期健康妊娠孕妇100例为对照组,比较两组的妊娠结局。结果 感染组不良妊娠结局发生率为20.00%,高于对照组的7.00%,差异有统计学意义（P<0.05）。结论 妊娠期生殖道感染与不良妊娠结局有关,需要及早采取措施进行防治。     

中孕期胎儿孤立性股骨及肱骨短小的临床预后

目的:探讨中孕期经超声诊断的无结构畸形和染色体异常的孤立性股骨及肱骨短小胎儿发生不良妊娠结局的风险。方法:回顾性分析2013年1月至2017年12月于我院行中孕期系统超声检查诊断为股骨及肱骨短小的病例(研究组),并进行妊娠期及产后的追踪随访,通过与正常对照组比较,评价股骨及肱骨短小胎儿的预后情况。结果:研究组75例,同时纳入对照组200例。妊娠期,研究组发生胎儿脐动脉频谱异常、子痫前期的几率高于对照组(分别为8.0%vs 1.0%及6.7%vs 0.5%,P<0.05)。研究组患儿出生体质量低于对照组(2763.1 g vs 3111.6 g,P<0.01),其早产率(20.0%vs 9.5%,P<0.05)、低出生体质量儿及小于胎龄儿发生率(分别为22.7%vs 9.0%及20.0%vs 8.5%,P<0.01)均高于对照组。长骨短小胎儿预后不良的比例是对照组的3.8倍(95%CI 1.9～7.3)。结论:妊娠中期超声检查发现的孤立性股骨及肱骨短小胎儿出现妊娠期并发症及不良妊娠结局的风险较高,有必要进行恰当的产前咨询、密切的围生期监护及产后随访。     

妊娠时机对妊娠合并系统性红斑狼疮病情及妊娠结局的影响

目的:探讨妊娠时机对妊娠合并系统性红斑狼疮(SLE)患者孕期病情及妊娠结局的影响.方法:对46例妊娠合并SLE孕妇的临床资料进行回顾性分析,按妊娠时机的不同分为两组:SLE控制期和缓解期达6个月以上怀孕者为指导性妊娠组(32例);SLE活动期怀孕者以及孕期新发SLE的病例为非指导性妊娠组(14例),比较两组患者孕期SLE的病情和妊娠结局的不同.结果:①指导性妊娠组孕期SLE的活动率和泼尼松用量分别为15.6％和9.6±1.1 mg/d明显低于非指导性妊娠组100％和24.1±18.2 mg/d(P =0.000,P=0.012).②指导性妊娠组24小时尿蛋白定量、肌酐、抗dsDNA抗体等指标的异常率均较非指导性妊娠组明显降低(P=0.003,P=0.004,P=0.021).③指导性妊娠组无一例母婴死亡;非指导性妊娠组产妇死亡1例,胎儿丢失5例.指导性妊娠组的活产率(100％)较非指导性妊娠组(64.3％)明显升高(P=0.001);胎儿丢失和胎儿生长受限发生率分别为0和18.8％,较非指导性妊娠组35.7％和50.0％明显降低(P=0.001,P=0.030).结论:妊娠时机对妊娠合并SLE患者孕期是否出现狼疮活动以及妊娠结局,尤其是胎儿结局影响较大,选择在SLE病情稳定半年以上计划怀孕,妊娠结局较好.     

Severe sepsis and septic shock in pregnancy: indications for delivery and maternal and perinatal outcomes

Objective: To report maternal and perinatal outcomes in obstetric patients with severe sepsis and septic shock. Methods: We performed a retrospective study of obstetric patients admitted to an intensive care unit (ICU) for severe sepsis/septic shock. Maternal clinical characteristics, hemodynamic profiles, laboratory findings, and perinatal outcomes were evaluated. Patients with severe sepsis (N = 20) and septic shock (N = 10) were compared using Fisher’s Exact and Mann–Whitney U tests. Results: Pyelonephritis was the most common etiology overall (37%) and acute respiratory distress syndrome (ARDS) was the most common organ injury in both severe sepsis (50%) and septic shock (80%). Liver dysfunction was present in cases with increased morbidity as a late finding and was the least frequent organ injury. Patients with septic shock had significantly higher rates of disseminated intravascular coagulation (DIC) (p = 0.01), altered mental status (p ≤ 0.001), total bilirubin >4?mg/dl (p = 0.04), failure in ≥3 organ systems (70% vs. 15%, p = 0.005), and maternal death (30% vs. 0%, p = 0.03). All patients with septic shock were delivered during hospitalization vs. 40% with severe sepsis. 71% of viable pregnancies required emergent cesarean delivery, and 50% of these for worsening respiratory function. Conclusions: ARDS is frequently found in critically ill obstetric patients with severe sepsis/septic shock and is associated with a high risk of emergent cesarean delivery.     

孕期非产科手术87例围手术期管理及妊娠结局分析

目的探讨孕妇在孕期行非产科手术时麻醉方式、手术因素及患者是否存在感染对母胎的影响。 方法回顾性分析广州医科大学附属第三医院2015年1月至2018年8月收治的87例因非产科疾病行手术治疗孕妇的临床资料,分析患者疾病分类、最终分娩孕周、分娩方式、早产及流产率等妊娠结局,比较不同孕期、不同手术方式、麻醉方式及感染并发症对妊娠结局的影响。 结果87例患者疾病分类：急性阑尾炎35例(40.2%),宫内妊娠合并宫外孕7例(8.1%),卵巢囊肿蒂扭转9例(10.3%),卵巢肿物21例(24.1%),泌尿系结石13例(14.9%),胆囊结石2例(2.3%);不同孕期接受非产科手术孕妇妊娠结局比较,差异无统计学意义(P>0.05);不同手术方式孕妇的分娩孕周、分娩方式、流产率、早产率等方面比较,差异无统计学意义(P>0.05);椎管内麻醉及全身麻醉在分娩方式、分娩孕周、早产及流产等方面比较,差异无统计学意义(P>0.05)。孕妇合并感染对妊娠结局有影响,孕妇合并感染情况对妊娠结局有影响,感染组分娩孕周低于对照组[(34.7±0.7)周与(38.5±0.2)周,Z＝5.088,P<0.05]。感染组剖宫产率、早产率和流产率均高于对照组[41.7% (10/24)与31.7% (20/63), χ²＝7.585;50% (12/24)与7.9% (5/63), χ²＝19.588;50.0% (12/24)与0, χ²＝29.659;P值均<0.05]。 结论孕期行非产科手术仍然可以获得较满意的妊娠结局,对于病情稳定的患者,不同孕期进行手术、不同麻醉方式和不同手术方式对妊娠结局影响没有差别,但对于合并感染的患者,病情本身的进展可能会影响妊娠结局。     

Mitral valve surgery and maternal and fetal outcome in valvular heart disease.

OBJECTIVES: To compare maternal and fetal outcomes in patients with non-operated valvular heart disease and patients who had surgery before or during pregnancy. METHODS: The 308 women with valvular heart disease who delivered in this hospital in the last 8 years were divided into three groups. The 218 (70.7%) women in group 1 had no surgical intervention; the 42 (13.6%) women in group 2 underwent balloon mitral valvotomy during pregnancy; and the 48 (15.5%) women in group 3 had surgical intervention before pregnancy (35 had balloon mitral valvotomy, eight had mitral valve replacement, and five had mitral valve repair). Maternal and fetal outcomes were compared for these three groups. RESULTS: The antenatal events differed significantly: 175 (80.3%), 40 (94.2%), and 46 (95.8%) patients in groups 1, 2 and 3, respectively, had uneventful pregnancies. In group 1, 14 (6.4%) patients had congestive heart failure (P>0.05) and 24 (11%) patients had cardiac arrhythmias, which was statistically significant. The rate of preterm deliveries did not differ significantly among the three groups. The groups did not differ in mean birth weight, mode of delivery, low birth weight, Apgar scores less than 8, stillbirths, neonatal death, or congenital anomalies. CONCLUSIONS: Mitral valve surgery before or during pregnancy did not significantly improve maternal and fetal outcomes but decreased adverse events such as congestive heart failure and cardiac arrhythmias. It should be therefore performed only in selected cases.     

The impact of maternal ketonuria on fetal test results in the setting of postterm pregnancy

OBJECTIVE: The aim of this study was to determine whether ketonuria, a commonly assessed urinary marker of maternal starvation and dehydration, is associated with abnormal fetal test results in the setting of postterm pregnancy. STUDY DESIGN: During a 4-year period (January 1993-December 1996), a total of 3655 visits for antepartum maternal-fetal testing of postterm pregnancies (> or =41 weeks' gestation) occurred at our institution. Maternal assessment included vital signs and urinalysis. The presence and degree of maternal ketonuria was correlated against abnormal results of fetal heart rate tests, nonstress tests, amniotic fluid index measurements, and biophysical profile scores performed on the same day. RESULTS: There were 3601 encounters suitable for inclusion in the study. Clinically detectable ketonuria occurred in 10.9% of the patients studied. Patients with clinically detectable ketonuria were at increased risk relative to patients without ketonuria for abnormal outcomes during postterm testing, including the presence of oligohydramnios (24% vs. 9.3%; P<.0001 ), nonreactive nonstress tests (6.2% vs. 2.15%; P<.0001), and fetal heart rate decelerations (14% vs 9.2%; P =.0039 ). CONCLUSION: Maternal ketonuria among patients with postterm pregnancy was associated with a >2-fold increase in the occurrence of oligohydramnios, a 3-fold increase in nonreactive nonstress tests, and a significant increase in fetal heart rate decelerations. Further studies are required to evaluate the potential benefits of treating ketonuria before fetal testing.     

41例妊娠期和产后脓毒症病例分析

目的探讨妊娠期和产后脓毒症的临床及微生物学特征、治疗特点与母儿结局。 方法回顾性研究2006年1月至2017年12月在北京大学深圳医院住院的妊娠期和产后脓毒症患者的临床资料,分析指标包括临床特征、微生物学特征、治疗情况及母儿结局。 结果41例妊娠期和产后脓毒症病例中13例(31.7%)生殖系统感染,9例(21.9%)泌尿系统感染,8例(19.5%)呼吸系统感染;26例患者,血培养阳性(63.4%),最常见的致病菌为大肠埃希菌(10株,35.7%),患者住院时间7～61 d,平均为18 d。最常选用的抗生素为静脉滴注抗β-内酰胺酶抗生素(17例,41.5%),其次是碳青霉烯类抗生素(13例,31.7%),抗生素治疗时间6～61 d,平均为15 d。8例(19.5%)患者需要外科手术干预。41例孕产妇中,39例治愈出院,2例患者死亡。围产儿结局中,分娩活婴22例,19例不良围产儿。 结论妊娠期和产后脓毒症常导致不良妊娠结局,原发感染主要是生殖系统感染、泌尿系统感染和呼吸系统感染,最常见的感染细菌为大肠埃希菌;正确应用抗生素和必要时手术干预至关重要。     

Observations on 72 cases of septic abortions

This study examines the effect of liberalizing abortion on the number of septic abortions and complications. 72 women with postabortal sepsis (up to 20 weeks of gestation) admitted at the K.E.M. Hospital in Bombay comprised the study group. A detailed medical history was obtained and a thorough clinical examination conducted. 29.16% of the patients were unmarried and 41.66% were primigavidas. Dilatation and curettage were performed in 36 cases; colpotomy in 8; and laparotomy in 3. Maternal mortality rate was 11.11% and septic shock was the cause of maternal deaths in 75% of the cases. Of the 8 women who died, 6 had a history of criminal interference, suggesting that there are still women who avail of abortion services outside the hospitals and peripheral centers. Medical termination of pregnancy should not be taken lightly as it is not without complications. The incidence of sepsis and its sequelae would be reduced if adequate asepsis and proper selection of cases, and control of vaginal infection before performing abortion, are observed.     

Septic shock and sepsis syndrome in obstetric patients

Septic shock is a life-threatening clinical syndrome that, despite its rare occurrence in obstetrics, remains a leading cause of maternal mortality. Its pathophysiology is explained by a profound systemic response to a complex variety of host cellular and humoral mediators elaborated after exposure to microbial toxins. Early recognition, prompt diagnostic workup, and immediate initiation of therapy improve outcomes. Therefore, recent publications have popularized the concept of the "sepsis syndrome," a preshock list of clinical criteria associated with progressive sepsis. Needed diagnostic studies should never be withheld because of "pregnancy concerns." With critically ill patients, the risk-to-benefit ratio supports the use of these diagnostic studies in almost all circumstances. Standard therapy is directed principally at restoring tissue perfusion by intravascular volume expansion and in some instances vasoactive pharmacological intervention. Simultaneously, identification of the source of infection and commencement of appropriate empiric antibiotic treatment are critical. In some cases, surgical abscess drainage or debridement of infected necrotic tissue will need to be considered. Novel approaches to treatment that attempt to reduce the systemic response to microbial toxins are promising and under active investigation. Pregnancy-specific considerations include the following: 1) initial signs or symptoms of septic shock may be masked by normal physiologic alterations of pregnancy; 2) a mixed polymicrobial group of organisms, consistent with lower genital tract flora, should be anticipated; and 3) initial therapy should be directed at maternal concerns since adverse fetal effects are most likely the result of maternal decompensation.     

Septic abortions: 5 years review

A study of maternal deaths due to septic abortion from 1973-77 in India found the incidence of septic abortion to be 6.6% of all spontaneous abortion in the L.N.J.P. Hospital. The total maternal deaths were 81 and deaths due to septic abortion were 17. The death rate due to septic abortions remained constant during the 5-year period. The majority of cases were married and belonged to the urban population. Of a total 6418 medically terminated pregnancies, 190 were septic abortions. The causes of death were generalised peritonitis (4); septicaemia (4); uraemia (2); endotoxic shock (2); uterine perforation with peritonitis (2); pelvic abcess and pulmonary embolism (1); and tetanus (2). In view of the high number of septic abortion deaths, medically terminated pregnancy services should be reapprised. Preventive contraception would alleviate most of the potential dangers of septic abortion.     

Maternal serum levels of macrophage colony-stimulating factor are associated with adverse pregnancy outcome

OBJECTIVE: The aim of this study was the measurement of maternal serum levels of M-CSF throughout pregnancy, in a low risk obstetrical population, to examine the relationship of M-CSF and pregnancy outcome. STUDY DESIGN: Maternal serum was obtained at various stages of pregnancy and post partum, M-CSF levels were measured by ELISA, pertinent clinical data tabulated, and pregnancy outcome was determined. RESULTS: In 564 pregnancies studied, 22% of 260 nulliparous pregnancies and 10% of 304 multiparous pregnancies were hypertensive. Preeclampsia occurred in 1.5% of nulliparous and in 1% of the multiparous women. In apparently normal pregnancies with good outcome, M-CSF levels rose throughout pregnancy. No cases of preeclampsia occurred if maternal serum M-CSF levels increased more than 100% throughout pregnancy. CONCLUSIONS: This study suggests that absolute levels and relative changes in maternal serum M-CSF levels during pregnancy are associated with adverse pregnancy outcomes.     

Retrospective analysis of outcome of pregnancy in women with congenital heart disease: Single-centre experience from North India

Objective: To study maternal and perinatal outcome in congenital heart disease (CHD) and to compare outcome between cyanotic and acyanotic CHD.
Method: A retrospective analysis of 196 cases of CHD was undertaken, and maternal and perinatal outcome of pregnancy was compared in cyanotic and acyanotic cases and between surgically corrected and uncorrected cases.
Results: Maternal and perinatal outcome was better in the acyanotic group. Maternal complications included higher incidence of cardiac complications in cyanotic group, (33.3% vs 3.4% in acyanotic group, P  = 0.001), abruption (12.5% vs nil) and pregnancy-induced hypertension (16.6% vs 5.2%). Rate of prematurity (25% vs 11.6%), intrauterine growth retardation (50% vs 15.1%, P  = 0.003) and abortion (4.1% vs 2.1%) was higher in cyanotic group. Mean gestational age at delivery was better in corrected group, 37.13 vs 34.93 weeks in uncorrected group. There was no case of infective endocarditis. There were four cases of maternal mortality in cyanotic group, two of which were in women with Eisenmenger syndrome. In acyanotic heart disease one case died undelivered and one died on first postoperative day.
Conclusion: Maternal and perinatal outcome is better in acyanotic CHD compared to cyanotic CHD. Surgical correction of cardiac lesions prior to conception improves outcome.