OUTCOME IN WOMEN WITH HEART DISEASE FROM JAN 2014-DEC 2014 AT - - PowerPoint PPT Presentation

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Nov 25, 2023 146 likes •341 views

MATERNAL AND PERINATAL OUTCOME IN WOMEN WITH HEART DISEASE FROM JAN 2014-DEC 2014 AT GANDHI HOSPITAL, SECUNDERABAD. By Dr. Sumalatha- Asst Prof Dr.J.V Reddy-Prof & H.O.D Department of OBG&GYN Gandhi Medical college . 000005 WCC

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MATERNAL AND PERINATAL OUTCOME IN WOMEN WITH HEART DISEASE FROM JAN 2014-DEC 2014 AT GANDHI HOSPITAL, SECUNDERABAD.

Dr. Sumalatha- Asst Prof

Dr.J.V Reddy-Prof & H.O.D Department of OBG&GYN Gandhi Medical college.

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TOTAL DURATION OF STUDY 12 MONTHS (Jan 2014-Dec 2014) TOTAL DELIVERIES 10007 PREGNANT WOMEN WITH HEART DISEASE 116 INCIDENCE OF HEART DISEASE 1.15% PREGNANT WOMEN WITH CRHD 80(68.9%) PREGNANT WOMEN WITH CONGENITAL HEART DISEASE 23(19.8%) OTHER FORMS OF HEART DISEASE 13(11.2%)

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AGE DISTRIBUTION * Total of 107/116(92.24%) were in the age group of 20-30yrs.

4 58 49 5 10 20 30 40 50 60 70 <20 YRS 20-25 YRS 26-30 YRS >30 YRS

No. of Patients

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PARITY NYHA FUNCTIONAL CLASS 16.3% were in class III or IV during pregnancy.

54 62 50 55 60 65 PRIMI MULTI 76 21 11 8 20 40 60 80 NYHA CLASS I NYHA CLASS II NYHA CLASS III NYHA CLASS IV

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Diagnosis of heart disease- Relation to present pregnancy Most of the cases (90.5%)were diagnosed and

n treatment before the present pregnancy.

11 cases(9.4%) were diagnosed during present pregnancy.

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Different types of heart disease seen in our study Congenital heart disease(CHD): Most of the CHD were ASDs(65.21%). Chronic Rheumatic Heart disease(CRHD):

SURGICALLY CORRECTED DURING CHILDHOOD 6 UNCORRECTED 17 Isolated MS/Predominant MS with other lesions 48 (60%) Isolated MR/Predominant MR with other lesions 32 (40%)

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Other heart diseases

Peripartum Cardiomyopathy 11(9.4%) myocardial infarction ( angioplasty) 1 WPW syndrome 1

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Pregnancy after surgical intervention done for cardiac disease.

CORRECTED CONGENITAL HEART DISEASE 6 PBMV 6(1 case underwent PBMV during 2nd trimester) PBAV 1(underwent during 2nd trimester) MITRAL VALVE REPLACEMENT 5 BOTH AORTIC &MITRAL VALVE REPLACEMENT 3

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Mode of delivery: One woman died undelivered.

VAGINAL 78(67.8%) LSCS 37(32.1%) VERTEX 68 ASSISTED BREECH 6 TWINS 2 VBAC 2

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Anaesthesia for LSCS: CAESAREAN DELIVERY:

EMLSCS 26 ELLSCS 11 GRADED EPIDURAL 30(81%) (preferred anaesthesia) SPINAL 3 GENERAL 4 (NYHA 3&4, on anticoagulants)

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INDICATIONS FOR LSCS

CPD , 3 IUGR , 2 PR LSCS , 16 FETAL DISTRESS , 4 SEVERE PIH& ABNORMAL DOPPLER , 6 MALPRESENTATI ON , 6

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ASSOCIATED OBSTETRIC COMPLICATIONS: 60/116 (51.7%) pregnancies were having complications.

ANEMIA , 7 PIH , 15 TWINS , 2 APH , 2 IUGR , 2 OLIGO , 4 PR LSCS , 16 MALPRESEN TATION , 12

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CARDIAC FAILURE, 4

ATRIAL FIBRILLATION , 7

LRTI, 5

PULMONARY EDEMA, 4

MEDICAL COMPLICATIONS 20/116 (17.24%) Had above complications

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Maternal mortality: 6/116 cases died (5.1%)

AGE PARITY & GA HEART DISEASE NYHA OBS COMP DELIV ERY MED COMP DELIV- DEATH INTER 26 PRIMI,3 2WKS SEVERE MS,EF-50% III Severe preeclampsia AF undelive red 25 G2P1L1, 32WKS Mod MR,Mild MS,AR, PAH,EF-55% III Sever preeclampsia,1 prlscs SPVD Pulmonar y edema 3 HRS 27 G2P1L1, 36WKS PPCM,Global hypokinesia, EF-22% IV SPVD 2HRS 24 G2P1L1, 36WKS Sever MS,EF- 35% III Sever preeclampsia SPVD 2hr:45m n 28 G3P2L2, 36WKS Severe MS,EF-48% III SPVD AF 3:30 HRS 23 G2P1L1, 35WKS, 1prlscs Severe MS,PS,mild PAH III preeclampsia EmLSC S Pulmonar y edema 6HRS

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PERINATAL OUTCOME: Out of 115 cases

TERM 88 PRETERM 24 LIVE BABIES 110 IUD 5 STILL BORN 2

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Birth weight

19 43 48 7 10 20 30 40 50 60 <2Kg 2.1-2.5Kg 2.6-3Kg 3-3.5Kg 9 3 4 2 5 10 Preterm MSL RD IUGR

Nursery admission

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Comparative studies

Chhetri etal,1 yr study, at tertiary care hospital, Nepal, march 2012- march 2013. Kiranmayi et al 2yr 9 months study at GMH, Nayapul,2005 Present study ,12 months at Gandhi hospital(jan-14-dec- 14) INCIDENCE 0.6% 0.51% 1.15% CRHD 89% 67.4% 68.9% MS 62% 52.6% 60% VAGINAL 56% 73.27% 67.8% LSCS 44% 26.73% 32.1% PRETERM

23.4% MATERNAL MORTALITY 4% 1 CASE 6 CASES

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THANK YOU

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