Maternal and perinatal outcome in rheumatic heart disease. |
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Authors: | H Sawhney N Aggarwal V Suri K Vasishta Y Sharma A Grover |
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Affiliation: | Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. |
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Abstract: | OBJECTIVES: To study the maternal and perinatal outcome of pregnancies complicated by rheumatic heart disease. METHODS: 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. RESULTS: 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. CONCLUSIONS: Rheumatic heart disease in pregnancy is associated with significant maternal and perinatal morbidity in NYHA class III-IV patients. |
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Keywords: | Rheumatic heart disease Balloon mitral valvotomy Closed mitral valvotomy Infective endocarditis prophylaxis |
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