Maternal heart disease and perinatal outcome.

Between January 1991 and August 1992, 62 singleton pregnancies with heart disease were managed at the Wadia Maternity Hospital, Bombay. In 51 (82.3%), the heart disease was of rheumatic origin, while in 11 (17.7%), the disease was nonrheumatic. Thirteen cases of rheumatic disease (25.4%) were graded as Class III or IV, as per New York Heart Association (NYHA) classification. Six cases with rheumatic disease had closed mitral commisurotomy done, while none had a prosthetic heart valve. There was no maternal mortality. The average birth weight of neonates born to mothers with Class III or IV rheumatic heart disease was significantly lower (p < 0.05) than the average noted in singleton, normal, uncomplicated, non high risk pregnancies, during this period. There was also a significant difference (p < 0.05) in birth weight between infants born to mothers with NYHA Class I or II and Class III or IV symptoms. No infant had a congenital heart disease. Our findings suggest that though the presence of maternal heart disease did not affect the perinatal outcome, all infants born to mothers with NYHA Class III or IV had intrauterine growth retardation.