Naila Yasmeen, Mahmood Aleem, Nasir Iqbal.
Feto-maternal outcome in patients with cardiac disease in pregnancy.
Pak J Med Health Sci Jan ;5(4):748-51.

Objective: To determine the fetal and maternal outcome in women presenting with heart disease during pregnancy. Study design: Descriptive study. Place and duration: Department of obstetrics/Gynae Unit-I, Allied Hospital, Faisalabad from January, 2009 to December, 2011. Patient and methods: Forty pregnant women with heart disease were attended during study period. Maternal outcome measuring included obstetric and medical complications and maternal mortality while fetal outcome measures were prematurely, intrauterine growth restriction perinatal mortality, intrauterine death and indicated termination of pregnancy. Result: Forty cases of heart disease were diagnosed out of 7000 obstetric patients giving a frequency of 0.62%. Twenty five (62.57) patients were in age group 21 – 25 and were primigravida while fifteen (37.5%) patients were in age group (30-35) (75%) and were multigravida. Thirty patients were unbooked. Rheumatic heart disease was the commonest aetiology and was found in 34 (85%) patients. Mitral valve was involved in all cases. Out of remaining six (15%) patients two (5%) patients had peripartum Cardiomyopathy, one (2.5%) patient had Ischemic heart disease. One (2.5%) patient had primary pulmonary hypertension, one (2.5%) patient had ventricular septal defect and one (2.5%) patient had Eisenmenger’s syndrome. One (2.5%) patient had mitral commissurotomy, and three (7.5%) patients had prosthetic valve replacement. Based on New York Heart Association Functional Classification (NYHA) 30 (75%) patients were asymptomatic (class-I) and 3 (7.5%) patients were in class-IV. Twenty five (62.5%) patients were delivered vaginally and in fourteen (35%) of cases LSCS was performed. There is only one (2.5%) maternal death. The fetal outcome of forty cases was 35 live births with average weigh of 2 Kg. Low birth weight babies numbered in 16 (40%) cases. Six (15%) patients delivered prematurely. One (2.5%) intrauterine death occurred in a mother who died undelivered. One (2.5%) patient had therapeutic termination of pregnancy.

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