Maternal and Fetal Outcome in Pregnancies Complicated by Rheumatic Heart Disease: A Single-Centre Experience

Objectives: To assess maternal and fetal outcome in pregnancies complicated with RHD (Rheumatic heart disease). Methods: A retrospective study which was carried out in high risk pregnancy unit over 18 months duration on 156 women having RHD (not having any valvular surgery). All patients had a multi dispensary team follow up of obstetrician, cardiologist and obstetric anesthesiologist all through their pregnancy with interpretation of fetal and maternal outcome. Results: Women who had RHD were 92% of all pregnant cardiac patients in our unit, mean maternal age 28.6±4.5ys; mean gestational age at time of termination 37.4±3.2ws. MS (mitral stenosis) was the commonest lesion (76.9%) either alone or associated with other lesions. 94.2% of patients were NYHA (New York heart association) class 1, 11. Regarding the mode of delivery it was 51 vaginal deliveries (32.7%), 102 CS (65.4%) and 3 abortion (1.92%). No maternal mortality, 12 maternal morbidities (acute pulmonary edema, sub rectus hematoma, puerperal sepsis, subs acute bacterial endocarditis). 3 IUFD and 6 neonates needed assisted ventilation. Conclusion: RHD is still a common disease in Egypt. Maternal and fetal morbidity and mortality are correlated with maternal cardiac functional classification.