Summera Aslam, Faizan Kashif, Kashif Zaheer, Aleena Kashif, Sibghat Ullah, Tayyiba Wasim.
Frequency of Fetomaternal Complications in pregnant females having valvular heart disease - a four years experience.
J Cardiovascular Dis Jan ;17(1):30-7.

BACKGROUND: Several hemodynamic changes occur during pregnancy which can adversely affect the outcome, especially in presence of pre existing cardiac lesion. Valvular cardiac lesions are the commonest type of acquired cardiac lesions, most common cause being rheumatic heart disease especially in developing countries. Maternal morbidity and mortality remains a significant problem in untreated valvular lesions. AIMS & OBJECTIVE: To assess the frequency of fetomaternal complications in pregnant females with valvular heart disease. MATERIAL & METHODS: It was a 4 years cross sectional study from January 2014 to December 2017 conducted at Gynae Unit 3 SIMS/Services Hospital Lahore. All the pregnant patients with valvular heart disease were included in this study. All the data was collected from registers and patient files and entered in a detailed performa. RESULTS: During the period 14,473 deliveries were conducted. Out of these, 217(1.5%) patients had cardiac problem, with 147(68%) patients having valvular heart disease. Mean age of the patients was 27.67 +- 7.835 years. Regarding fetal outcome IUGR was noted in 40 (27.21%) patients, there were 35(23.8%) preterm births, 26 (17.7%) miscarriages, 6(4.1%) still births, 3(2%) neonatal deaths and no complications were noted in 36 (24.5%) patients. There was only 1 (0.68%) anomalous baby. Regarding maternal outcome, no complications were noted in 79 (53.74%) patients, 51 (34.69%) patients suffered from pulmonary edema, 9 (6.12%) patients had atrial fibrillation, and stroke was noted in 2 (1.36%) patients while 2 (1.36%) patients suffered from hypertension. There were only 4(2.72%) maternal deaths. CONCLUSION: The fetomaternal outcome is better in those patients where some form of treatment is provided for valvular cardiac lesion. Accurate diagnosis, tailored therapy and an understanding of the physiology and pathophysiology of pregnancy are necessary components of management. Multi disciplinary approach i.e. collaboration of a team of trained obstetricians, cardiologists, anesthetists and pediatricians may result in successful fetomaternal outcome in majority of cases. KEY WORDS: Valvular heart disease, Fetomaternal outcome, Pregnancy.

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