Abstract

Heart disease complicates 1% of all pregnancies. Cardiac abnormalities are considered the leading non-obstetric cause of maternal morbidity and mortality. Though rare in developed country, rheumatic heart disease is still predominant in developing countries and continues to be a major cause of maternal morbidity and mortality. Methods: prospective observational study, Study setting: OBGY department of Tertiary care center. Study population: The study population included all the pregnancy patients with RHD admitted in tertiary care center. Sample size: 85 Results: A total of 85 women were enrolled in this study. Sixty percent of the women were primigravida. Mitral stenosis was the commonest lesion (69.41%), followed by mitral regurgitation (25.88%) and aortic stenosis (4.71%). Cardiac events were noted in 32 patients out of which 11 developed pulmonary oedema and 6 had new onset of atrial fibrillation. Vaginal delivery (58.82%) was the commonest mode of delivery followed by cesarean section (24.7%). Eighty percent of women remained in NYHA functional class I and II, whereas 20% had deterioration of functional class. There were more maternal and fetal complications in women with NYHA III or IV in comparison to women with NYHA I or II. Low birth weight infants were found in 37.64% of cases. There was one maternal death in a lady with severe mitral stenosis with moderate mitral regurgitation due to congestive heart failure at 34 weeks of gestation. There were 8 fetal and 11 neonatal death. Conclusions: Functional cardiac status during pregnancy has a major impact on maternal and fetal outcome. Rheumatic heart disease diagnosed before pregnancy may improve the outcome

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