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Maternal and fetal outcome in valvular heart disease
Author(s) -
Malhotra M.,
Sharma J.B.,
Tripathii R.,
Arora P.,
Arora R.
Publication year - 2004
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(03)00317-5
Subject(s) - medicine , valvular heart disease , pregnancy , heart disease , incidence (geometry) , apgar score , obstetrics , heart failure , fetus , cardiology , genetics , physics , optics , biology
Objectives: To compare the pregnancy outcomes of women having valvular heart disease with the pregnancy outcomes of healthy women. Methods: A retrospective comparison of the maternal and fetal pregnancy outcomes of 312 women with valvular heart disease and 321 healthy women cared for at a tertiary care hospital during the same period. Statistical analysis was done using the χ 2 ‐test, with significance fixed at 0.05. Results: Women with valvular heart disease had a significantly higher incidence of surgical interventions during pregnancy than women in the control group [13.4% (balloon mitral valvotomy) vs. 0.6% (ovarian cystectomy)], congestive heart failure (5.1% vs. 0%, P <0.001), and mortality [0.64% (two women) vs. 0%]. Perinatal outcome was also more adverse in the valvular heart disease group than in the control group, with increased preterm delivery rate (48.3% vs. 20.5%), reduced birth weight (2434±599 g vs. 2653±542 g; P <0.001), and a higher incidence of APGAR scores less than 8 (8.3% vs. 4%; P <0.01). There was also a higher rate of instrumental delivery (9.9% vs. 3.4%). However, the rate of cesarean deliveries was similar in the two groups. Conclusions: Pregnancy in women with valvular heart disease is associated with significantly higher maternal morbidity and adverse fetal outcomes and requires a team approach for optimal management.