STUDY OF MATERNAL AND PERINATAL OUTCOMES IN HEART DISEASES IN PREGNANCY AT A TERTIARY CARE HOSPITAL

Abstract

Objective:
To evaluate maternal and perinatal outcomes in pregnant women with heart disease at a tertiary care hospital and to determine the association of functional status with adverse outcomes.

Study Design:
Prospective observational study.

Place and Duration of Study:
Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre (JPMC), Karachi, conducted over a period of 6 months.

Methodology:
A total of 100 pregnant women diagnosed with congenital or acquired heart disease were included. Patients were followed throughout pregnancy, delivery, and the postpartum period. Data regarding demographic characteristics, type of cardiac disease, and New York Heart Association (NYHA) functional class were recorded. Maternal outcomes (heart failure, arrhythmias, ICU admission, and maternal mortality) and perinatal outcomes (preterm birth, low birth weight, Apgar score, NICU admission, and perinatal mortality) were assessed. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. Chi-square test was applied to determine associations, and a p-value ≤0.05 was considered statistically significant.

Results:
The majority of patients were aged 20–30 years (58%) and multigravida (60%). Rheumatic heart disease was the most common condition (55%), followed by congenital heart disease (30%). Most patients were in NYHA Class II (45%). Maternal complications included heart failure (22%), arrhythmias (15%), and ICU admission (18%), with a maternal mortality rate of 3%. Cesarean section was performed in 50% of cases. Among perinatal outcomes, preterm birth occurred in 28%, low birth weight in 32%, NICU admission in 26%, and perinatal mortality in 6% of cases. Patients with higher NYHA class (III–IV) had significantly increased adverse maternal (66%) and perinatal outcomes (63%) compared to those in Class I–II (p < 0.05).

Conclusion:
Heart disease in pregnancy is associated with considerable maternal and perinatal morbidity and mortality. Higher NYHA functional class is a significant predictor of adverse outcomes. Early risk stratification and multidisciplinary management are essential to improve maternal and fetal prognosis