Maternal and Fetal Outcome Among Women with Heart Diseases

Objective: The main objective of the present study is to examine maternal fetal outcome in patients with heart disease among a hospital sample of pregnant women.Setting: King Abdul-Aziz University in Jeddah.Method: Retrospective analysis of all patients recorded in the labor room registry as having heart disease over a period of 20 years from Jan-1986 to Dec-2005. For each patients demographic data, fetal and maternal outcome were recorded. In addition the clinical grading of the heart disease as assessed by the NYHA [1] system during pregnancy and after delivery as well as the etiological and pathological diagnosis of cardiac was noted.Results: During the study period a total of 56, 082 deliveries had taken place in KAUH, 288 cases of heart disease were identified. The majority were cases of rheumatic heart disease 198 patients (68.75%), followed by congenital heart disease 78 patients (27.08%), next were cases of coronary heart disease 6 patients (2.08%), then were cases of cardiomy¬opathy 4 patients (1.38%), 2 (0.69%) were miscellaneous.Clinical grading of heart disease during and after delivery showed that 9 out of 74 patients in class I had deteriorated, five became in class II while four became in class III.18 out of 154 patients in class II had deteriorated, 14 became in class III, while 4 became in class IV. All patients in class III (11) had deteriorated to class IV. Out of 4 patients in class IV, 3 patients died.Forty five patients who underwent heart surgery prior to pregnancy were evaluated separately, all patients (24) in class I remained in the same class post delivery. 12 patients (66%) from class II were post delivery reallocated to class I, while the rest (6) remained in the same class. One patient in class III remained in the same class, while the other one improved. One patient in class IV died.