Cardiac disease in pregnancy

被引:94
作者
Bhatla, N [1 ]
Lal, S
Behera, G
Kriplani, A
Mittal, S
Agarwal, N
Talwar, KK
机构
[1] All India Inst Med Sci, Dept Obstet & Gynecol, New Delhi, India
[2] All India Inst Med Sci, Dept Cardiol, New Delhi, India
关键词
pregnancy; cardiac disease; maternal morbidity; low birth weight; prosthetic valve; anticoagulant;
D O I
10.1016/S0020-7292(03)00159-0
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objectives: To evaluate the maternal and fetal outcome of pregnancies complicated by cardiac disease in a developing country. Methods: A retrospective analysis was carried out of 207 pregnancies in women with cardiac disease who delivered at greater than or equal to28 weeks of gestation from June 1994 through December 2000 at a tertiary care center. Results: Rheumatic heart disease (n=183, 88%) with isolated mitral stenosis (n=71) was the predominant cardiac problem. Septal defects were the most common form of congenital heart disease (n=24). In 28 (13.52%) women, the diagnosis of cardiac disease was made during pregnancy. Cardiac complications were noted in 62 (29.95%) and fetal complications in 42 (20.28%) pregnancies. Patients in NYHA class I/II (n=175, 84.54%) had fewer maternal complications and their babies had a higher birth weight than those in NYHA class III/IV (n= 32, 15.45%). Cardiac intervention was performed prior to pregnancy in Ill (60.65%) patients with rheumatic heart disease: PTMC/CMV in 73 and valve replacement (VR) in 38. Maternal and fetal outcome was better in patients with prosthetic valves (n=38) and the majority (97.4%) of them remained in NYHA class I/II. Cardiac intervention was safely carried out during pregnancy in 10 women (PTMC in 7, CMV in 1, and VR in 2). One of them developed congestive cardiac failure during labor. None of the newborns of the 41 women who had received anticoagulants had any congenital malformation. Conclusions: Rheumatic heart disease was the predominant type. Patients in NYHA class I/II had a better maternal and fetal outcome than those in NYHA class III/IV. Surgical correction of the cardiac lesion prior to pregnancy was associated with better pregnancy outcome. Pregnant women with prosthetic valves tolerated pregnancy well. (C) 2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:153 / 159
页数:7
相关论文
共 19 条
[1]   BETA-ADRENERGIC-RECEPTOR BLOCKADE IN THE MANAGEMENT OF PREGNANT-WOMEN WITH MITRAL-STENOSIS [J].
ALKASAB, SM ;
SABAG, T ;
ALZAIBAG, M ;
AWAAD, M ;
ALBITAR, I ;
HALIM, MA ;
ABDULLAH, MA ;
SHAHED, M ;
RAJENDRAN, V ;
SAWYER, W .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1990, 163 (01) :37-40
[2]  
CLARK SL, 1991, OBSTET GYN CLIN N AM, V18, P237
[3]   Maternal mortality: Confidential enquiries into maternal deaths in the United Kingdom [J].
de Swiet, J .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2000, 182 (04) :760-766
[4]   Mitral stenosis in pregnancy: a four-year experience at King Edward VIII Hospital, Durban, South Africa [J].
Desai, DK ;
Adanlawo, M ;
Naidoo, DP ;
Moodley, J ;
Kleinschmidt, I .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2000, 107 (08) :953-958
[5]   Balloon mitral valvotomy in pregnancy: Maternal and fetal outcomes [J].
Gupta, A ;
Lokhandwala, YY ;
Satoskar, PR ;
Salvi, VS .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 1998, 187 (04) :409-415
[6]   The effect of valvular heart disease on maternal and fetal outcome of pregnancy [J].
Hameed, A ;
Karaalp, IS ;
Tummala, PP ;
Wani, OR ;
Canetti, M ;
Akhter, MW ;
Goodwin, M ;
Zapadinsky, N ;
Elkayam, U .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2001, 37 (03) :893-899
[7]   PREGNANCY AND PROSTHETIC HEART-VALVES - A FRENCH COOPERATIVE RETROSPECTIVE STUDY OF 155 CASES [J].
HANANIA, G ;
THOMAS, D ;
MICHEL, PL ;
GARBARZ, E ;
AGE, C ;
MILLAIRE, A ;
ACAR, J .
EUROPEAN HEART JOURNAL, 1994, 15 (12) :1651-1658
[8]   SHORT-TERM AND LONG-TERM RESULTS OF CATHETER BALLOON PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY [J].
HUNG, JS ;
CHERN, MS ;
WU, JJ ;
FU, M ;
YEH, KH ;
WU, YC ;
CHERNG, WJ ;
CHUA, S ;
LEE, CB .
AMERICAN JOURNAL OF CARDIOLOGY, 1991, 67 (09) :854-862
[9]   PREGNANCY COMPLICATED BY MATERNAL HEART-DISEASE - A REVIEW OF 519 WOMEN [J].
MCFAUL, PB ;
DORNAN, JC ;
LAMKI, H ;
BOYLE, D .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1988, 95 (09) :861-867
[10]   CLOSED MITRAL VALVOTOMY DURING PREGNANCY - A 20-YEAR EXPERIENCE [J].
PAVANKUMAR, P ;
VENUGOPAL, P ;
KAUL, U ;
IYER, KS ;
DAS, B ;
SAMPATHKUMAR, A ;
AIRON, B ;
RAO, IM ;
SHARMA, ML ;
BHATIA, ML ;
GOPINATH, N .
SCANDINAVIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1988, 22 (01) :11-15