Maternal and Fetal Outcome in Cardiac Patients: A Cross-Sectional Study at Tertiary Care Setting

Background: The presence of cardiac diseases in pregnancy is a high-risk condition and poses a threat to both mother and child. This study aimed to determine maternal and fetal pregnancies in women with cardiac disease at a tertiary care hospital. Methodology: This was aretrospective study conducted in the Department of Obstetrics and Gynecology, Aga Khan University Hospital, Karachi, from January 2013 to December 2015. All pregnant women with cardiac diseases were enrolled in the study. Mean (SD) was used for continuous variables, while percentages were calculated for categorical variables. Chi-square test was applied to compare the maternal and fetal outcome with the severity of functional class. A p-value of less than 0.05 was considered significant. Results: The average maternal age was 29.8 +/- 5.2 years. Rheumatic heart disease was present in 47% and congenital heart disease in 28.8% of pregnant women. Almost 80% of women belonged to NYHA functional class I and II. Overall maternal complications were GDM, Preeclampsia, pulmonary edema, PPH, CCF, Arrhythmias, Cardiogenic and septic shock. GDM, preeclampsia, pulmonary edema mainly occurred in congenital heart disease patients. Perinatal outcomes included 93.2% live births, 3% neonatal, and 3% intrauterine deaths. Significant associations were found between pulmonary edema, use of Digoxin & Diuretics, and NYHA functional class. Conclusion: The current study indicates that cardiac diseases are associated with adverse maternal and fetal outcomes. These women require aggressive monitoring and time management. Therefore, such patients should be regularly followed and counseled.