Maternal and perinatal outcome in rheumatic heart disease

Int J Gynaecol Obstet. 2003 Jan;80(1):9-14. doi: 10.1016/s0020-7292(02)00029-2.

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.

MeSH terms

  • Adult
  • Female
  • Gestational Age
  • Heart Valve Diseases / mortality
  • Heart Valve Diseases / surgery*
  • Humans
  • India
  • Infant, Newborn
  • Outcome Assessment, Health Care*
  • Pregnancy
  • Pregnancy Complications / mortality
  • Pregnancy Complications / surgery*
  • Pregnancy Outcome*
  • Prognosis
  • Retrospective Studies
  • Rheumatic Heart Disease / mortality
  • Rheumatic Heart Disease / surgery*
  • Severity of Illness Index