PERINATAL OUTCOME IN PREGNANCY COMPLICATED BY MATERNAL HEART DISEASE

Abstract

Background: Maternal heart disease is a significant contributor to perinatal morbidity and mortality worldwide. With the rising age of conception and increasing prevalence of cardiovascular risk factors, the incidence of cardiac disease complicating pregnancy is steadily increasing. Rheumatic and congenital heart diseases are the most common types encountered during pregnancy. Given the hemodynamic changes inherent to gestation, affected women require diligent monitoring and multidisciplinary management to optimize outcomes. Understanding the perinatal impact of maternal cardiac disease is essential to guide preventive strategies and improve care delivery.

Objective: To determine the perinatal outcomes in pregnancies complicated by maternal heart disease.

Methods: A descriptive case series was conducted over a six-month period at the Department of Gynaecology and Obstetrics, CMH Lahore. A total of 100 pregnant women diagnosed with heart disease were enrolled after meeting the inclusion criteria. All participants were prospectively followed until delivery. Mode of delivery, perinatal outcomes including spontaneous abortion and preterm birth, and postpartum complications such as hemorrhage and congestive cardiac failure were recorded. Postpartum follow-up extended for 24 hours to assess early maternal complications.

Results: The mean age of enrolled patients was 29±3 years. Rheumatic heart disease was the predominant lesion found in 61% of cases, followed by congenital heart disease in 29% and ischemic cardiomyopathy in 10%. Mitral stenosis was the most common valvular defect (50.8%), and atrial septal defect was the most prevalent congenital anomaly (72.4%). Spontaneous abortion occurred in 18% of pregnancies. Cesarean section was the mode of delivery in 67% of cases. Postpartum congestive cardiac failure developed in 50% of the patients, making it the most frequent complication observed.

Conclusion: Maternal heart disease continues to impose a considerable burden on pregnancy outcomes, with rheumatic and congenital heart lesions being the most prevalent. Early detection, thorough surveillance, and multidisciplinary care remain crucial to improving maternal and neonatal prognosis.