MATERNAL AND FETAL OUTCOMES IN PREGNANT WOMEN WITH CARDIAC DISEASES: A CROSS-SECTIONAL STUDY FROM A TERTIARY CARE HOSPITAL IN KARACHI, PAKISTAN.

Abstract

Objective: To determine the maternal and fetal outcomes in pregnant women with cardiac diseases delivering at a tertiary care hospital. Study Design: Cross-sectional study.

Setting: Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre (JPMC), Karachi.

Period: Four months from Jan 2025 to April 2025.

Methods: A total of 110 with known cardiac disease and >24 weeks of gestation were chosen, using non-probability consecutive sampling. Data recorded were the type of cardiac lesion, the NYHA classification, the EF, and the delivery data. SPSS v25 was used to analyze the data. Chi-square or Fisher exact test was used for categorical data; the Mann-Whitney U test for continuous data. Independent predictors were determined by binary logistic regression.

Results: Cardiac illness was the most common condition observed, with 66.4% as the most frequent heart disease. 21.8% had a composite adverse maternal outcome, and 43.6% had an adverse fetal outcome. The delivery data and the NYHA class for the III and IV categories were: adverse maternal outcome. Ejection fraction < 45% was observed for adverse maternal outcome. Demographic and echocardiographic data as well as clinical characteristics of heart failure were documented (100% compared to 10.4%, p < 0.001). The most powerful independent predictor on multivariable analysis was the NYHA 3/4 (aOR 12.57, 95% CI 0.96–164.5, p = 0.054).

Conclusion: When pregnancies were complicated by cardiac disease, 20% (1/5) had serious maternal complications. Rheumatic disease and advanced NYHA class are most important to the mother and fetus.