May 2018 · Volume 7 · Issue 5 Page 1949 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Rathore S et al. Int J Reprod Contracept Obstet Gynecol. 2018 May;7(5):1949-1952 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Original Research Article A five year retrospective study on maternal and perinatal outcome in pregnancy after cardiac surgery Swati Rathore 1 , Ravi Shankar 2 *, Annie P. Vijjeswarapu 1 , Anuja Abraham 1 , Bijesh Yadav 3 INTRODUCTION Pregnancy is a hypercoaguablestate with physiological haemodynamic changes occurring during pregnancy. 1,2 There is a progressive increase in intravascular volume in second trimester of pregnancy and increase in cardiac output. 3 Pregnancy makes a significant impact on cardiovascular system. It is important to evaluate and study the effect of pregnancy on women with surgically corrected heart conditions so as to preempt potential complications. Pregnancies complicated with maternal cardiac diseases have an incidence of 1-4%. Most of these can be managed with lifestyle changes and medical management. Pregnancy following cardiac surgery puts both mother and fetus at risk. Maternal mortality rate can be as high as 10-30%. 4 Pregnancy among women with mechanical prosthetic valve is associated with arisk of maternal death of between 1 and 4%. 5 Thus patients with artificial heart valves need an enhanced level of care during pregnancy and labour. 6 Mortality is mainly due to thrombotic complications. Neither surgical nor medical treatment is ideal for pregnant women with acute prosthetic heart valve dysfunction. Hence appropriate time and the mode of delivery prior to the therapy when ABSTRACT Background: Pregnancy is a hypercoaguable state with physiological haemodynamic changes occurring during pregnancy. There is a progressive increase in intravascular volume in second trimester of pregnancy and increase in cardiac output. Pregnancy makes a significant impact on cardiovascular system. It is important to evaluate and study the effect of pregnancy on women with surgically corrected heart conditions so as to preempt potential complications. Methods: This is a retrospective study of patients with prior history of cardiac surgery and their pregnancy outcomes in a tertiary center of Southern India over a period of five years from January 2011 to December 2016. Results: In this study, descriptive statistical analysis was done in 87 women with pregnancy following cardiac surgery. 58.6% were nulliparous. Around 52% had associated obstetric risk factors. The most common cardiac surgery in this population was Mitral valve replacement (40.2%) and Atrial septal defect closure (37.9%). Women belonged to NYHA class I in 90.8% of cases. 58.6% had vaginal delivery and 36.8% had caesarean section. 6 women had postpartum haemorrhage which was medically managed, and 6 women needed ICU care.74.7% women had term deliveries. 18.4 % of the babies were less than 2.5 kg weight at birth. 13 babies required Neonatal ICU care. Conclusions: Maternal and neonatal outcome mainly depends on the functional cardiac status of women before conception. In this study we emphasize on the importance of multidisciplinary team approach involving cardiologist, obstetrician and neonatologist in the management of women with prior cardiac surgery. Keywords: Cardiac surgery, Functional cardiac status, Pregnancy outcome 1 Department of Obstetrics and Gynecology, 2 Department of Cardiothoracic Surgery, 3 Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India Received: 01 March 2018 Accepted: 28 March 2018 *Correspondence: Dr. Ravi Shankar, E-mail: ravixshanker@gmail.com, Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20181935