Publication: Maternal cardiac diseases complicating pregnancy: a review of 105 cases
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Date
2001
Article Type
Original Article
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Volume Title
Pages
Pages: 14 - 22
Publisher
Institute of Medicine
Abstract
Abstract
The outcome of pregnancies in 105 patients with heart diseases in TUTH, Kathmandu, Nepal between April 1995 and May 2001 was reviewed. The incidence of heart disease was 0.55% of the total 19038 deliveries. Rheumatic (79), congenital (17) and miscellaneous groups (9) complicated the pregnancy. Significant number (53) had their diagnosis made at the index pregnancy. Patients who developed cardiac failure (17) mostly did during antenatal period (20-42 weeks); the majority had cardiac failure (14) at third trimester. Two of the cases that had cardiac failure at 33 weeks ultimately had stillbirths later at term. Induction of labour for such cases, which was discouraged earlier, should be considered. In our hospital labour analgesia with epidural anaesthesia, pethidine or morphine is not a routine practice. Injection Methergin is also generally withheld. Save one or two, most Cesaerean sections had obstetrical indication. Prophylactic forceps or ventouse were barely used.
There were two maternal deaths. One of them had pregnancy complication as eclampsia and presented with SVT and MI at 34 weeks. The other case died within 48
hours of Caesarean delivery for critical mitral stenosis with pulmonary hypertension. The perinatal losses were 7. This article strongly emphasizes the need for routine cardiac evaluation of patients at their very first antenatal check up so that patie nts with cardiac disease can benefit from shared co-operation between cardiologist, cardiothoracic surgeon, anaesthelogist and obstetrician.
Keywords: Heart disease, pregnancy, cardiac failure, obstretic analgesia, induction of labour
Description
Keywords
Heart disease, pregnancy, cardiac failure, obstretic analgesia, induction of labour
Identifier
https://doi.org/10.59779/jiomnepal.150