To Find out Maternal and Fetal Outcome of Cardiac Disease in Pregnancy

Aim: To determine maternal and fetal outcome of cardiac disease during pregnancy. Setting: Services Hospital, Lahore. Duration of Study: One year from January 2010 to December 2010. Study Design: Retrospective study. Sample Size: Twenty nine patients. Results: Out of 29 patients 5 were PG. Twenty one patients were between G2-5 and only 6 patients were G6 onward. Twenty four patients were delivered vaginally. Caesarean sections were carried out in 5 patients. So, in cardiac patients, the mode of delivery was vaginal and C/S were carried out for obstetrical reasons. Ninety eight percent of patients had either class-I or class-II cardiac disease. Only 1(3%) patient had class-III cardiac disease. Ten (34%) patients had valve replacement. All these patients had their mitral valves replaced. No patient had aortic valve replacement. Most of the patients 24(83%) were booked and only 5(17%) were unbooked. All the booked patients also had evaluation from anaesthetist at the time of admission to have fitness from anaesthetist in case of emergency LSCS. In all the booked patient fresh echocardiography was carried out to know the status of her cardiac disease. Even when the unbooked patients were presented in the labour room both the cardiologist and the anaesthetist were involved. There was no maternal death and even no serious maternal morbidity. Ten patients had mitral valve replacement. No patient developed thrombus on the valve. Fetal outcome was good. There was no congenital defect in the babies due to warfarin. Conclusion: Good maternal fetal outcome can occur in booked patients of cardiac disease with proper obstetric and cardiac care. Most of patients in Pakistan still have rheumatic heart disease.