Skip to main content

Advertisement

SpringerLink
Log in

Heart disease in pregnancy: cardiac and obstetric outcomes

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

A retrospective analysis of the records of all the patients of heart disease with pregnancy at AIIMS, New Delhi, India, to find out the maternal and fetal outcome.

Materials and methods

A retrospective analysis was carried out of 100 pregnancies in women with heart disease who delivered at ≥28 weeks of gestation from July 2009 through August 2012.

Results

Cardiac disease was found to complicate 3.8 % of pregnancies. Rheumatic heart disease (n = 64, 64 %) was the predominant cardiac disease. Congenital heart disease was found to complicate 36 pregnancies (n = 36, 36 %).Cardiac complications were seen in 32 (32 %) and fetal complications in 18 (18 %) pregnancies. Fewer cardiac and postpartum complications were present in NYHA class I/II patients compared to NYHA III/IV patients (P < 0.05). Pregnancy outcome was better in rheumatic heart disease patients who had undergone cardiac intervention prior to pregnancy (n = 29, 45.2 %) compared to those whose heart disease remained uncorrected (n = 35, 54.8 %) but the difference was not statistically significant. There was one maternal mortality in a patient with Eisenmenger syndrome. Two of the newborns of the 17 women who had received anticoagulants had features of warfarin embryopathy.

Conclusion

Pregnancy in women in NYHA class III/IV is associated with significantly higher maternal morbidity and cardiac interventions before pregnancy, when indicated may improve pregnancy outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. International Institute for Population Sciences (IIPS) and Macro International (2007). National Family Health Survey (NFHS-3), 2005–06: India

  2. Maternal Mortality in 2005(2007). Estimates developed by WHO, UNICEF, UNFPA, and The World Bank. World Health Organization

  3. Roeder HA, Kuller JA, Barker PC, James AH (2011) Maternal valvular heart disease in pregnancy. Obstet Gynecol Surv 66(9):561–571

    Article  PubMed  Google Scholar 

  4. Madazli R, Sal V, Cift T, Guralp O, Goymen A (2010) Pregnancy outcomes in women with heart disease. Arch Gynecol Obstet 281(1):29–34

    Article  PubMed  Google Scholar 

  5. Bhatla N, Lal S, Behera G, Kriplani A, Mittal S, Agarwal N, Talwar KK (2003) Cardiac disease in pregnancy. Int J Gynecol Obstet 82:153–159

    Article  CAS  Google Scholar 

  6. Doshi HU, Oza HV, Tekani H, Modi K (2010) Cardiac disease in pregnancy-maternal and perinatal outcome. J Indian Med Assoc 108(5):278–280

    PubMed  Google Scholar 

  7. Aggarwal N, Suri V, Kaur H, Chopra S, Rohila M, Vijayvergia R (2009) Retrospective analysis of outcome of pregnancy in women with congenital heart disease: single-centre experience from North India. Aust N Z J Obstet Gynaecol 49:376–381

    Article  PubMed  Google Scholar 

  8. Melchiorre K, Sharma R, Thilaganathan B (2012) Cardiac structure and function in normal pregnancy. Curr Opin Obstet Gynecol 24(6):413–421

    Article  PubMed  Google Scholar 

  9. Sillesen M, Hjortdal V, Vejlstrup N, Sorensen K (2011) Pregnancy with prosthetic heart valves- 30 years’ nationwide experience in Denmark. Eur J Cardiothorac Surg 40:448–454

    PubMed  Google Scholar 

  10. Radford DJ, Walters DL (2004) Balloon aortic valvotomy in pregnancy. Aust N Z J Obstet Gynecol 44:577–579

    Article  Google Scholar 

  11. Sivadasanpillai H, Srinivasan A, Sivasubramoniam S (2005) Long-term outcome of patients undergoing balloon mitral valvulotomy in pregnancy. Am J Cardiol 95:1504–1506

    Article  PubMed  Google Scholar 

  12. Hameed A, Karralp IS, Tummula PP, Wani OR, Canetti M, Akhter MW et al (2001) The effects of valvular heart disease on maternal and fetal outcome of pregnancy. J Am Coll Cardiol 37:893–899

    Article  PubMed  CAS  Google Scholar 

  13. Desai DK, Adanlawo M, Naidoo DP, Moodley J, Kleinschmdt I (2000) Mitral stenosis in pregnancy: a four-year experience at King Edward VIII Hospital, Durban, South Africa. Br J Obstet Gynaecol 107:953–958

    Article  CAS  Google Scholar 

  14. Silversides CK, Colman JM, Sermer M (2003) Cardiac risk in pregnant women with rheumatic mitral stenosis. Am J Cardiol 91:1382–1385

    Article  PubMed  Google Scholar 

  15. Malhotra M, Sharma JB, Arora P, Batra S, Sharma S, Arora R (2003) Mitral valve surgery and maternal and fetal outcome in valvular heart disease. Int J Gynecol Obstet 81:151–156

    Article  CAS  Google Scholar 

  16. Malik HT, Sepehripour AH, Shipolini AR, McCormack DJ (2012) Is there a suitable method of anticoagulation in pregnant patients with mechanical prosthetic heart valves? Interact Cardiovasc Thorac Surg 15(3):484–488

    Article  PubMed  Google Scholar 

  17. Bian C, Wei Q, Liu X (2012) Influence of heart-valve replacement of warfarin anticoagulant therapy on perinatal outcomes. Arch Gynecol Obstet 285(2):347–351

    Article  PubMed  CAS  Google Scholar 

  18. Suri V, Keepanasseril A, Aggarwal N, Chopra S, Bagga R, Sikka P, Vijayvergiya R (2011) Mechanical valve prosthesis and anticoagulation regimens in pregnancy: a tertiary centre experience. Eur J Obstet Gynaecol Reprod Biol 159:320–323

    Article  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India

    Murali subbaiah, Vaishali Sharma, Sunesh kumar, Kallol Kumar Roy, Jai Bhagwan Sharma & Neeta Singh

  2. Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India

    S. Rajeshwari

  3. Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India

    Shyam Sunder Kothari

  4. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Room No 254, I Main Road, 12th Block, 2nd Stage, Nagarbhavi, Bangalore, 560072, India

    Murali subbaiah

Authors
  1. Murali subbaiah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vaishali Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sunesh kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Rajeshwari
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shyam Sunder Kothari
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kallol Kumar Roy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jai Bhagwan Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Neeta Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Murali subbaiah.

Rights and permissions

Reprints and permissions

About this article

Cite this article

subbaiah, M., Sharma, V., kumar, S. et al. Heart disease in pregnancy: cardiac and obstetric outcomes. Arch Gynecol Obstet 288, 23–27 (2013). https://doi.org/10.1007/s00404-013-2730-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-013-2730-2

Keywords

Search

Navigation