Materno-fetal Outcome and Its Correlation with Modified WHO Class in Women with Heart Disease Referred to Teaching Tertiary Care Centre

To evaluate Materno-fetal outcome in pregnancies complicated by heart disease and its correlation with Modified WHO class of maternal cardiovascular risk.

A retrospective analysis was carried on 30 pregnant women with heart disease delivering > 28 weeks over a period of 24 months, at a tertiary level teaching hospital. All women were assigned Modified WHO class and their medical records were reviewed for Materno-fetal outcome and cardiac complications.

The mean age of women was 25.1±3.22 years. RHD (n=22, 73.33%) was the predominant heart disease followed by congenital heart disease (n=5, 16.67%) and peripartum cardiomyopathy (n=3, 10%). In majority (n=20;66.67%) cardiac problem was first diagnosed during pregnancy. Majority (n=21, 70%) of women were in Modified WHO class III/IV. Eleven (50%) women with RHD had undergone cardiac intervention: PTMC/CMV in 7 and MVR in 4. Two out of these eleven cardiac interventions were carried out successfully during index pregnancy: PTMC in 1 and MVR in 1. Maternal cardiac complications were noted in 7(23.33%) and fetal complications in 16 (53.33%). There was one (3.33%) maternal mortality in postpartum period but there was no perinatal mortality. Women in Modified WHO class II/II-III had statistically significant fewer maternal cardiac complications and preterm deliveries but not statistically significant higher fetal birth weight than those in class III/IV.

RHD was still the predominant heart disease and surgical correction prior to pregnancy was associated with better pregnancy outcome. Women in Modified WHO class II/II-III had a better maternofetal outcome than those in class III/IV. Majority (91.67%) women needing ICU care belonged to Modified WHO class III/IV