OUTCOME IN WOMEN WITH HEART DISEASE FROM JAN 2014-DEC 2014 AT - PowerPoint PPT Presentation

MATERNAL AND PERINATAL OUTCOME IN WOMEN WITH HEART DISEASE FROM JAN 2014-DEC 2014 AT GANDHI HOSPITAL, SECUNDERABAD. By Dr. Sumalatha- Asst Prof Dr.J.V Reddy-Prof & H.O.D Department of OBG&GYN Gandhi Medical college . 000005 WCC & IVUS 2015

TOTAL DURATION OF STUDY 12 MONTHS (Jan 2014-Dec 2014) TOTAL DELIVERIES 10007 PREGNANT WOMEN WITH HEART 116 DISEASE INCIDENCE OF HEART DISEASE 1.15% PREGNANT WOMEN WITH CRHD 80(68.9%) PREGNANT WOMEN WITH CONGENITAL 23(19.8%) HEART DISEASE OTHER FORMS OF HEART DISEASE 13(11.2%) 000005 WCC & IVUS 2015

AGE DISTRIBUTION 70 58 60 No. of Patients 49 50 40 30 20 5 10 4 0 <20 YRS 20-25 YRS 26-30 YRS >30 YRS * Total of 107/116(92.24%) were in the age group of 20-30yrs. 000005 WCC & IVUS 2015

PARITY 65 62 60 54 55 50 PRIMI MULTI NYHA FUNCTIONAL CLASS 76 80 60 40 21 11 20 8 0 NYHA NYHA NYHA NYHA CLASS I CLASS II CLASS III CLASS IV 16.3% were in class III or IV during pregnancy. 000005 WCC & IVUS 2015

Diagnosis of heart disease- Relation to present pregnancy Most of the cases (90.5%)were diagnosed and on treatment before the present pregnancy. 11 cases(9.4%) were diagnosed during present pregnancy. 000005 WCC & IVUS 2015

Different types of heart disease seen in our study Congenital heart disease(CHD): SURGICALLY CORRECTED 6 DURING CHILDHOOD UNCORRECTED 17 Most of the CHD were ASDs(65.21%). Chronic Rheumatic Heart disease(CRHD): Isolated MS/Predominant MS 48 (60%) with other lesions Isolated MR/Predominant MR 32 (40%) with other lesions 000005 WCC & IVUS 2015

Other heart diseases Peripartum Cardiomyopathy 11(9.4%) myocardial infarction 1 ( angioplasty) WPW syndrome 1 000005 WCC & IVUS 2015

Pregnancy after surgical intervention done for cardiac disease. CORRECTED CONGENITAL HEART 6 DISEASE PBMV 6(1 case underwent PBMV during 2 nd trimester) 1(underwent during 2 nd trimester) PBAV MITRAL VALVE REPLACEMENT 5 BOTH AORTIC &MITRAL VALVE 3 REPLACEMENT 000005 WCC & IVUS 2015

Mode of delivery: VAGINAL 78(67.8%) LSCS 37(32.1%) One woman died undelivered. VERTEX 68 ASSISTED BREECH 6 TWINS 2 VBAC 2 000005 WCC & IVUS 2015

Anaesthesia for LSCS: GRADED EPIDURAL 30(81%) (preferred anaesthesia) SPINAL 3 GENERAL 4 (NYHA 3&4, on anticoagulants) CAESAREAN DELIVERY: EMLSCS 26 ELLSCS 11 000005 WCC & IVUS 2015

INDICATIONS FOR LSCS MALPRESENTATI ON , 6 IUGR , 2 CPD , 3 SEVERE PIH& ABNORMAL DOPPLER , 6 PR LSCS , 16 FETAL DISTRESS , 4 000005 WCC & IVUS 2015

ASSOCIATED OBSTETRIC COMPLICATIONS: ANEMIA , 7 MALPRESEN TATION , 12 PIH , 15 PR LSCS , 16 TWINS , 2 OLIGO , 4 IUGR , 2 APH , 2 60/116 (51.7%) pregnancies were having complications. 000005 WCC & IVUS 2015

MEDICAL COMPLICATIONS PULMONARY CARDIAC EDEMA, 4 FAILURE, 4 ATRIAL LRTI, 5 FIBRILLATION , 7 20/116 (17.24%) Had above complications 000005 WCC & IVUS 2015

Maternal mortality: 6/116 cases died (5.1%) AGE PARITY HEART NYHA OBS COMP DELIV MED DELIV- & GA DISEASE ERY COMP DEATH INTER 26 PRIMI,3 SEVERE III Severe AF undelive 2WKS MS,EF-50% preeclampsia red 25 G2P1L1, Mod MR,Mild III Sever SPVD Pulmonar 3 HRS 32WKS MS,AR, preeclampsia,1 y edema PAH,EF-55% prlscs 27 G2P1L1, PPCM,Global IV SPVD 2HRS 36WKS hypokinesia, EF-22% 24 G2P1L1, Sever MS,EF- III Sever SPVD 2hr:45m 36WKS 35% preeclampsia n 28 G3P2L2, Severe III SPVD AF 3:30 36WKS MS,EF-48% HRS 23 G2P1L1, Severe III preeclampsia EmLSC Pulmonar 6HRS 35WKS, MS,PS,mild S y edema 1prlscs PAH 000005 WCC & IVUS 2015

PERINATAL OUTCOME: Out of 115 cases TERM 88 PRETERM 24 LIVE BABIES 110 IUD 5 STILL BORN 2 000005 WCC & IVUS 2015

Birth weight 60 48 50 43 40 30 19 20 7 10 0 <2Kg 2.1-2.5Kg 2.6-3Kg 3-3.5Kg Nursery admission 9 10 4 5 3 2 0 Preterm MSL RD IUGR 000005 WCC & IVUS 2015

Comparative studies Chhetri etal,1 yr study, Kiranmayi et al 2yr 9 Present study ,12 at tertiary care hospital, months study at months at Gandhi Nepal, march 2012- GMH, Nayapul,2005 hospital(jan-14-dec- march 2013. 14) INCIDENCE 0.6% 0.51% 1.15% CRHD 89% 67.4% 68.9% MS 62% 52.6% 60% VAGINAL 56% 73.27% 67.8% LSCS 44% 26.73% 32.1% PRETERM - 9% 23.4% MATERNAL 4% 1 CASE 6 CASES MORTALITY 000005 WCC & IVUS 2015

THANK YOU 000005 WCC & IVUS 2015