Nazia Liaqat, Sher Bahadar Khan, Rehana Raheem.
Maternofetal outcome in patients with cardiac diseases in a tertiary care hospital.
Pak Heart J Jan ;51(1):36-40.

Objective: The aim of this study was to determine the maternal and fetal outcome in pregnant cardiac patients. Methodology: This cross sectional study was carried out in Gynae B unit of Lady Reading Hospital from January 2013 to 2016 . All cardiac patients with evidence of cardiac problem on echocardiography, presenting to labour suit were included.Patients presenting for termination of pregnancy before 24 weeks of gestation were excluded from the study. Complete cardiovascular and obstetrical examination was carried out. NYHA class was determined at the time of presentation. Maternal and fetal outcomes like C-section, postpartum haemorrhage, pulmonary edema and maternal death, prematurity, still birth and low birth weight were studied. Chi square test was applied for analyzing the data. Result: A total of 98 pregnant ladies with cardiac diseases were included. Out of 98 patients, 22% were newly diagnosed with cardiac disease while 78% were already diagnosed cardiac patients at time of study. About 69% of the patients were in the NYHA class I, II and 31% were in NYHA III, IV. Acquired heart lesions were present in 81% patients and congenital heart defects in the remaining 19%cases. Mitral stenosis being the most common problem accounting for 51% of cases. Peripartum cardiomyopathy was present in 12% of cases. Postpartum hemorrhage occurred in 22.4% of the patients,15.3% of the patients developed pulmonary oedema. The still birth frequency was 18%. Maternal death occurred in 4 (4%)of the cases (p<0.01). Conclusion: While some of the complications related to cardiac diseases in pregnant patients are unavoidable, proper pre and post pregnancy counseling can make a huge difference.

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