8. Maternal cardiac complications in women with cardiac disease in pregnancy

The aim of the present work is to identify the risk factors for maternal cardiac complications and for adverse neonatal outcome in women with heart disease in pregnancy. Prospective observational study was carried out at a tertiary referral hospital in South India. Data was collected from 144 women going through 146 pregnancies and delivered after 24 weeks of gestation, over a period of 7 years. Logistic regression analysis was done to identify the risk factors for maternal and the neonatal complications. Principal etiology of the lesion was Rheumatic in 67%, Congenital in 26% and peripartum cardiomyopathy in 5%. Maternal mortality was 2% (3 women) and maternal cardiac complications occurred in 27%. NYHA class III/IV at booking, pulmonary arterial hypertension and myocardial dysfunction were the risk factors for maternal cardiac complications during pregnancy. NYHA class III/IV, gestational age >20 weeks at booking and associated hypertension during present pregnancy were the risk factors for adverse neonatal outcome. RHD remains an important cause for maternal as well as perinatal mortality and morbidity in developing countries. NYHA class III/IV, myocardial dysfunction and pulmonary arterial hypertension are the risk factors for maternal cardiac complications.