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KMID : 1143220240670020218
Obstetrics & Gynecology Science
2024 Volume.67 No. 2 p.218 ~ p.226
Fetomaternal outcomes in pregnant women with congenital heart disease: a comparative analysis from an apex institute
Soniya Dhiman

Aparna Sharma
Akanksha Gupta
Richa Vatsa
Juhi Bharti
Vidushi Kulshrestha
Satyavir Yadav
Vatsla Dadhwal
Neena Malhotra
Abstract
Objective With advancements in cardiac surgical interventions during infancy and childhood, the incidence of maternal congenital heart disease (CHD) is increasing. This retrospective study compared fetal and cardiac outcomes in women with and without CHD, along with a sub-analysis between cyanotic versus non-cyanotic defects and operated versus non-operated cases.

Methods A 10-year data were retrospectively collected from pregnant women with CHD and a 1:1 ratio of pregnant women without any heart disease. Adverse fetal and cardiac outcomes were noted in both groups. Statistical significance was set at P<0.05.

Results A total of 86 pregnant women with CHD were studied, with atrial septal defects (29.06%) being the most common.
Out of 86 participants, 27 (31.39%) had cyanotic CHD. Around 55% of cases were already operated on for their cardiac defects. Among cardiovascular complications, 5.8% suffered from heart failure, 7.0% had pulmonary arterial hypertension, 8.1% presented in New York Heart Association functional class IV, 9.3% had a need for intensive care unit admission, and one experienced maternal mortality. Adverse fetal outcomes, including operative vaginal delivery, mean duration of hospital stay, fetal growth restriction, preterm birth (<37 weeks), low birth weight (<2,500 g), 5-minute APGAR score <7, and neonatal intensive care unit admissions, were significantly higher in women with CHD than in women without heart disease.

Conclusion Women with CHD have a higher risk of adverse fetal and cardiac outcomes. The outcome can be improved with proper pre-conceptional optimization of the cardiac condition, good antenatal care, and multidisciplinary team management.
KEYWORD
Cardio-vascular disease, Intrauterine growth restriction, High-risk pregnancy, Premature birth, Preconception care
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