Cardiac disease is one of the leading risk factor for maternal and neonatal morbidity and mortality worldwide. Hemodynamic changes pre-exist in women with cardiac disease and the physiological circulatory changes of pregnancy further add to this burden. The presence of cardiac lesions can increase the maternal mortality rate up to 17%.
Worsening cardiac status during pregnancy may need urgent surgical intervention during pregnancy. A study was carried out in the AIIMS, New Delhi, to assess the overall status of pregnancy outcome and management of pregnant women with cardiac disease at a tertiary care hospital in India.
During the study, published in the International Journal of Gynecology & Obstetrics, volume 82, out of a total of 9365 deliveries (ĄÝ28 weeks gestation age) conducted for a period of six and a half years, cardiac disease was found to complicate 293 (3.1%) pregnancies. The low incidence of maternal and neonatal mortality at this center in this study was suggested to be due to close monitoring of patients during pregnancy by obstetricians and cardiologists, surgical correction of the cardiac lesions in the majority (60.65%) of them and intensive neonatal care.
In conclusion, the study suggests the need for pre-pregnancy counseling, routine examination of the cardiovascular system for early diagnosis and appropriate management, close surveillance during pregnancy and a team approach comprising of obstetricians, cardiologists, neonatologists and nursing personnel for a successful pregnancy outcome.