The pregnancy outcome of acyanotic heart disease.

OBJECTIVE

To study the pregnancy outcome of women with acyanotic heart disease.

METHOD

This is a retrospective study from a tertiary referral centre in a developing country over a period of 3 years.

RESULTS

There were a total of 19,151 deliveries where 143 cases had heart disease in pregnancy, all of which were acyanotic, giving an incidence of 0.7%. Fifty-one (38.4%) of these were congenital whereas 82 (61.6%) were acquired. There was no cyanotic heart lesion during this study period. The fetal and maternal outcome of the women with heart disease (study group) was compared with the general obstetric population in the Unit (control group) using the Chi-squared test. Ninety-two percent in the study group were asymptomatic (NYHA Class I). The age distribution were no different except in the < 20 years interval where there were significantly fewer in the study group. More women with heart disease were primiparous and fewer were multiparous as compared with the controls. There was no significant difference in the rate of induction of labour (9.8% vs 11.8%). The use of epidural analgesia was significantly higher in the study group (49% vs 13%) as was the instrumental delivery rates (35.7% vs 5.7%) when compared with the controls. The caesarean section rate was no different. The mean gestation of babies born to mothers with heart disease was 38.2 weeks. Significantly fewer babies were in the 3.0-3.5 kg weight interval and more in the 2.5-3.0 kg interval. However, this did not alter the perinatal mortality rates which was not significantly different (15.3 vs 14.0 per thousand).

CONCLUSION

The fetal and maternal outcome in women with acyanotic heart disease was favourable. It is advocated that the management of these cases should be multidisciplinary to optimise care for these patients.