Outcome of Pregnancy among Parturients Complicated with Heart Disease in Rajavithi Hospital
Ekachai Kovavisarach MD*, Pantipa Nualplot MD*
Affiliation : * Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok
Objective : To compare the maternal and perinatal outcomes at Rajavithi Hospital from January 1st, 2000 to
December 31st, 2004,(5 years),(3rd period) with those occurring in the previous two periods: 1st and 2nd
(1965-1970,(6 years) and 1985-1990,(6 years) respectively.
Materials and Methods : Retrospective analysis of various medical records of 196 cases diagnosed pregnancy
with heart disease.
Results : The prevalence of parturients complicated with heart disease was 0.41%, an increase of 2 and 5 times
compared with the first and second period, respectively. Congenital heart disease was the most common type
of disorder in the second and third period (64.28% and, 49.49%, respectively) while rheumatic heart disease
was the most common disorder in the first period (54.86%). Most of the cases in the 2nd and 3rd periods were
delivered by operative vaginal delivery (46.43% and 44.90%, respectively),while spontaneous vaginal delivery
was the most common mode of delivery in the first period (78.99%). All of the postpartum and perinatal
complications except postpartum hemorrhage were significantly higher in the worse class of NYHA (class III/
IV) than those in the better class of NYHA (class I/II). The maternal death rate in the third period increased
1.81 times and 13.66 times compared with those in the first and second periods, respectively.
Conclusion : Congenital heart disease was the most common heart disease in pregnancy from 1985 to 1990
and 2000 to 2004. Patients in the NYHA class III/IV had worse maternal and fetal outcomes than those in the
NYHA class I/II except for postpartum hemorrhage. Maternal mortality rate was highest from 2000 to 2004
(12.57 per 100,000 live births).
Keywords : Heart disease, Pregnancy, Maternal outcome, Perinatal outcome
