scholarly journals Pregnancy Outcome in Women with Heart Disease in a Tertiary Care Centre in Kolkata, India

2021 ◽  
Vol 10 (18) ◽  
pp. 1309-1313
Author(s):  
Mihir Kumar Sarkar ◽  
Arindam Halder
Keyword(s):  
Heart Disease ◽  
Perinatal Outcome ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Multidisciplinary Care ◽  
Tertiary Care Centre ◽  
Second Stage Of Labour ◽  
Cardiac Lesions ◽  
Heart Lesions ◽  
Rheumatic Heart

BACKGROUND The incidence of cardiac lesions is less than 1 % amongst hospital deliveries. The commonest cardiac lesion is of rheumatic origin followed by the congenital ones. Heart diseases have a significant impact on maternal and perinatal morbidity and mortality. The purpose of the study was to find out the specific heart lesion in pregnancy in a particular demographic area and evaluate the maternal and perinatal outcome. METHODS This was a two-year retrospective observational study done by reviewing the records of all the mothers with heart diseases admitted for pregnancy from April 2016 to March 2018. RESULTS The study included 42 patients. The majority of heart lesions was mitral stenosis of rheumatic origin. Prophylactic forceps in second stage of labour was the major method of delivery. As far as the perinatal outcome is concerned, low birth weight and prematurity were the major problem in the babies born to these mothers. CONCLUSIONS With advances in medical care and surgical approach, the obstetricians should be prepared to manage an increasing number of women with heart disease during pregnancy. A combined multidisciplinary care is essential in managing these cases. KEY WORDS Rheumatic Heart Disease, Congenital Heart Disease, Cardiac Failure, Forceps Delivery, Prematurity

scholarly journals Maternal outcomes of rheumatic heart disease in pregnancy

2017 ◽  
Vol 6 (3) ◽  
pp. 802
Author(s):  
Hema Priya L. ◽  
Ambarish Bhandiwad ◽  
Nagaraj Desai ◽  
Triveni Kondareddy
Keyword(s):  
Heart Disease ◽  
Birth Weight ◽  
Functional Status ◽  
Rheumatic Heart Disease ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Heart Disease In Pregnancy ◽  
Rheumatic Heart ◽  
In Pregnancy

Background: Preexisting cardiac disease is seen in 1-3% of pregnancies. In developing countries, sequelae of rheumatic fever often constitute the majority of women with heart disease; whereas in developed countries, it is the congenital heart diseases. The aim of this study was to examine the changing trends and mode of care of women with Rheumatic heart disease in pregnancy over a period of five years in a tertiary care centre.Methods: Patient records over five years were retrieved and maternal and perinatal outcomes were documented. The present study reports the outcomes of 72 women with rheumatic heart disease.Results: The prevalence of heart disease in pregnancy in our study was 1.72%. The prevalence was higher among the rural population, and in lower socio economic strata. 30% of patients were diagnosed during pregnancy. The risk of complications co - related with their functional status at the onset of pregnancy. The mode of termination of pregnancy and indications for LSCS did not vary. However, the risk of complications was greatest during labour and post-partum period. The mean birth weight was 2.7 kg, however, 30% of term neonates were of low birth weight (<2.5 kg).Conclusions: Rheumatic heart disease continues to be a major cause of cardiac disease complicating pregnancy. However, early diagnosis, appropriate management prior to pregnancy, and good functional status at the time of entering pregnancy allowed for a good maternal and neonatal outcome.

scholarly journals Contemporary Pattern of Pediatric Infective Endocarditis from Tertiary Care Centre of Northern India: A Single Centre Experience

2021 ◽  
Vol 11 (01) ◽  
pp. e250-e254
Author(s):  
Dinesh Kumar ◽  
Shikha Garg ◽  
Dheeraj D. Bhatt
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Rheumatic Heart Disease ◽  
Tertiary Care ◽  
North India ◽  
Normal Heart ◽  
Tertiary Care Centre ◽  
Duke Criteria ◽  
Culture Negative ◽  
Rheumatic Heart

AbstractWith an increasing number of children with congenital heart disease (CHD) undergoing corrective treatments, improved pediatric intensive care, better antimicrobial treatments, and a relative decrease in rheumatic heart disease over the years, the epidemiology of pediatric infective endocarditis in India may be undergoing a change. The study was done in the department of pediatrics of a tertiary care teaching hospital of North India. A retrospective analysis of case records of children (<12 years) admitted with a diagnosis of infective endocarditis (IE) from January 2013 to April 2019 was performed. Modified Duke's criteria were used to diagnose IE. There were 21 children diagnosed with infective endocarditis during this period. The mean age at presentation was 70 months (range: 2.5–144 months). CHD (n = 13/21, 61.9%) was the most common predisposing condition. A total of 28% (6/21) patients had no preexisting structural heart disease. Nine percent (2/21) had rheumatic heart disease. Staphylococcus aureus was the most common etiological agent in those with a structurally normal heart. Most patients had blood culture–negative infective endocarditis (n = 12, 57.1%). Only one patient fulfilled Duke's major microbiological criteria. Six patients (28.57%) died during the hospital stay. Increasingly younger children are being diagnosed with infective endocarditis in India and a significant number of them are in the setting of a structurally normal heart. In view of high percentage of culture-negative endocarditis, the Duke criteria may need to be revised to retain their sensitivity in such settings.

scholarly journals Prevalence and Involvement of Different Valves in Rheumatic Heart Disease- An Observational Echocardiographic Study in a Tertiary Care Centre, Bengaluru, India

2021 ◽  
Author(s):  
S Lalitha ◽  
Vijay Sai ◽  
Prajith Pasam ◽  
V Bhargavi
Keyword(s):  
Developing Countries ◽  
Heart Disease ◽  
Mitral Valve ◽  
Rheumatic Heart Disease ◽  
Tertiary Care ◽  
Valve Disease ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Study Population ◽  
Rheumatic Heart

Introduction: Rheumatic Heart Disease (RHD) is a non suppurative sequelae of group A beta haemolytic streptococci, resulting from inadequately treated streptococcal sore throat or scarlet fever and leading to valvular heart disease. Rheumatic heart disease is a major cause of morbidity and mortality in younger population in developing countries. The present study was done at a tertiary care medical college hospital with the objective of establishing prevalence and involvement of different valve patterns by Echocardiography (ECHO). Aim: To analyse the valvular pattern of RHD over a period of four years in a tertiary care centre and highlight the importance of ECHO in the definitive diagnosis of RHD, and to know the continuing burden of RHD. Materials and Methods: This was a hospital based retrospective observational study conducted at Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India. A total of 518 cases of RHD were selected as a study population among the ECHO performed between January 2016 and January 2020 after an exclusion criterion of degenerative mitral and aortic valve disease, congenital aortic and mitral valve disease, myxomatous mitral valve disease, trivial and functional regurgitation. Analysis of valvular pattern was performed. Data analysis was done by tables, charts, percentages and ratio. Results: A total of 518 patients were diagnosed to have RHD by 2-Dimensional ECHO. Among them 276 (53%) were females and 242 (47%) were males. The average age was 41.9 years. The most common valve involved independently and in combined lesions was the mitral valve. Of the study population, 446 patients had Mitral Stenosis (MS) and 393 had Mitral Regurgitation (MR). Aortic Stenosis (AS) was found among 111 patients and 304 patients had Aortic Regurgitation (AR). Tricuspid Stenosis (TS) (organic) was found in seven cases. Multiple valves were involved in 204 cases. Among them 104 of the cases had MS, MR and AR, 69 cases had MS, MR, AS and AR, 21 cases had MS, AS and AR, seven cases had MR, AS and AR and three cases had MS, AS, AR and TS. Though aortic valve was involved in multi valvular lesions, significant AR (moderate and severe) was seen in 109 patients and significant AS (moderate and severe) was seen in 67 patients. Conclusion: RHD continues to be a major burden to population in developing countries. In the present study, various patterns of valvular involvement were noted. Drastic measures are to be taken primary and secondary prevention of RHD.

scholarly journals A study of pregnancy outcome in patients with cardiac disease

2018 ◽  
Vol 7 (12) ◽  
pp. 5111
Author(s):  
Pradnya D. Kamble ◽  
Amarjeet Kaur Bava
Keyword(s):  
Heart Disease ◽  
Cardiac Disease ◽  
Tertiary Care ◽  
Cardiac Complications ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Lower Segment Caesarean Section ◽  
Maternal Mortality And Morbidity ◽  
Rheumatic Heart

Background: Cardiac disease is a leading cause of maternal mortality and morbidity. Timely diagnosis and appropriate management can significantly improve the maternal and perinatal outcome.Methods: This prospective observational study was performed over a period of 18 months at a tertiary care centre in Mumbai. A total of 100 women with heart disease were included in the study. The subjects were followed up during the antenatal, intrapartum and postpartum period to study the maternal and perinatal outcome.Results: Out of 14791 confinements 100 consenting patients were included in the study. The incidence of heart disease came out to 0.9%. Rheumatic heart disease (RHD) was seen more commonly as compared to congenital heart disease (CHD) and peripartum cardiomyopathy. 64% patients delivered vaginally out of which 8% had instrumental delivery and 28% underwent a lower segment caesarean section (LSCS). 21% patients had cardiac complications like pulmonary edema, arrhythmias, sepsis, DIC etc. and there were 3 maternal mortalities. 58% of the babies were born low birth weight, 90.9% of the babies had an Apgar score of >7. 60% of the babies were born at term whereas 26% had a preterm delivery.Conclusions: Patients of cardiac disease with pregnancy need to be managed at a tertiary care centre by a multidisciplinary team of doctors. Early diagnosis of heart disease and stringent management of complication is of utmost importance. Vaginal delivery is favourable and LSCS should be performed for an obstetric indication. Maternal heart disease leads to an increased incidence of preterm delivery and hence a joint care of neonatologist is mandatory in managing these patients.

scholarly journals Feto–maternal outcome in pregnancy with Heart Disease: A tertiary care centre experience

2020 ◽  
Vol 9 (2) ◽  
pp. 59-62
Author(s):  
Anubhuti Mohan ◽  
Usha Mohan ◽  
Rahul Singla ◽  
Pratima Mittal ◽  
Divya Pandey ◽  
...  
Keyword(s):  
Heart Disease ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Tertiary Care Centre ◽  
Her Family ◽  
Term Delivery ◽  
Acquired Heart Disease ◽  
Cardiac Lesions

Aim and Objectives: To know the prevalence and etiological types of heart disease in pregnant female and to describe the foetal and maternal outcome. Methodology: A retrospective hospital based study of all women with congenital or acquired heart disease admitted in Safdarjung hospital in 2016 was performed. The etiological type of heart disease and maternal and neonatal outcome were evaluated. Results: Median age of all the patients enrolled was 25yrs (19yrs–31yrs) which included mostly multigravida with POG from 28 to 41 weeks of gestation. Among all the patients 62% were unbooked. Rheumatic heart disease was most prevalent followed by congenital heart disease (13.6%) and Cardiomyopathy (13.7%). It was also found in the study that Instrumental Vaginal delivery was the preferred method. The fetal outcome was also evaluated and it was found that Pre term delivery, Low Birth weight and IUGR were main complications found in the mothers with heart disease which resulted in 27% NICU admissions and 5.1% neonatal mortality. Conclusion: Cardiac lesions and pregnancy both may affect each other adversely. Joint care of obstetrician, cardiologist and anesthetist, avoidance of complications that add to the burden on the heart and compliance of the patient and her family to regular follow up will go a long way in ensuing a safe outcome for mother and fetus.

scholarly journals Spectrum of congenital heart disease in neonates in a tertiary care centre of Northern India

2018 ◽  
Vol 5 (4) ◽  
pp. 1505
Author(s):  
Mahvish Qazi ◽  
Najmus Saqib
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Cleft Lip ◽  
Heart Diseases ◽  
Heart Defects ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Tertiary Care Centre

Background: Congenital heart defects (CHDs) are an important cause of mortality and morbidity in children representing a major global health burden. Not much of Indian data is available particularly from this part of the country. So, authors conduct a retrospective study to know the spectrum of congenital heart disease in our set up.Methods: A retrospective hospital based study was carried out in the neonatal intensive care unit of SMGS Hospital, Jammu from January 2017 until December 2017 to see the spectrum of CHD.Results: There were 5552 neonates admitted during the study period out of which 68 were found to have CHD. The prevalence was 12.24 per 1000 admitted neonates. Out of 68 admitted neonates, 41were males (60.3 %) and 27 females (39.7%). Clinically Respiratory distress (51.47%) was the commonest presenting symptom followed by Cyanosis (16.18%), refusal of feed (13.23%) and murmer (10.3%).46 (67.65%) newborn had acyanotic and 22 (32.35%) cyanotic congenital heart lesions. Ventricular septal defect (27.94%) was the commonest acyanotic congenital heart defects whereas Tetrology of Fallot (14.70%) was the commonest cyanotic congenital heart diseases. Cleft lip and Cleft Palate was found in 12.5% followed by Down’s syndrome in 3.57% of cases of newborns with CHD. The mode of delivery was spontaneous in 64.71% followed by Elective LSCS were 23.53% and Emergency LSCS were 11.76%.Conclusions: There is an urgent need for government and non‑government organizations to establish well‑equipped cardiothoracic surgical centers across the country especially in Jammu to cater for children with CHDs.

Maternal and perinatal outcome in pregnancies with rheumatic heart disease

2000 ◽  
Vol 70 ◽  
pp. D70-D70
Author(s):  
K. Vasishta ◽  
H. Sawhney ◽  
N. Aggarwal ◽  
V. Suri ◽  
A. Grover ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Perinatal Outcome ◽  
Rheumatic Heart

scholarly journals Role of TEE in Improving Diagnostic Accuracy of Congenital Heart Disease

2014 ◽  
Vol 2 (2) ◽  
pp. 68-70
Author(s):  
Sandeep Singh Rana ◽  
Balbir Kumar ◽  
Sethu Madhavan J
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Diagnostic Accuracy ◽  
Multimodal Imaging ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Associated Lesions ◽  
Cardiac Lesions ◽  
Intraoperative Period

ABSTRACT Complex congenital heart diseases (CHD) often present as multiple cardiac lesions. The presence of one anomaly should stimulate the physician to perform a comprehensive assessment and look for other associated anomalies.1 Multimodal imaging may be necessary to diagnose such associated lesions as single imaging may occasionally miss them. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are complimentary to each other. Routine use of TEE during intraoperative period may help us to refine diagnosis, detect the missing components and guide effective surgical repair. We present one such case where diagnosis and management were optimized by multimodal imaging. How to cite this article Kumar B, Madhavan JS, Puri GD, Rana SS. Role of TEE in Improving Diagnostic Accuracy of Congenital Heart Disease. J Perioper Echocardiogr 2014;2(2):68-70.

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