PMM.45 Modes of delivery in obstetric cardiology patients – experience at a tertiary referral centre

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Abstract

Introduction

Cardiac disease is now the leading cause of maternal death in the United Kingdom and the RCOG advises that all women with a history of cardiac disease should have a risk assessment in a joint multidisciplinary clinic with a clear plan for delivery being drawn up.1

Aim

Does multidisciplinary team management of high risk women reduce the need for obstetric intervention in the intrapartum period?

Methods

Between September 2008 and January 2014, 290 patients attended our joint obstetric cardiology clinic for antenatal care. Patients attending are those with previously known or newly diagnosed cardiac disease in pregnancy. We conducted a prospective cohort study following the antenatal and intrapartum care of this group. We have compared the modes of delivery of these patients with the overall delivery modes at our university hospital. 35 patients delivered elsewhere have been excluded.

Results

There were no maternal or fetal deaths in our patients.

Conclusions

The vaginal delivery rate in our high risk group of patients was comparable to that of our background population. A clear management plan made by the multidisciplinary team for intrapartum care in women with heart disease which is well documented and widely distributed has helped us to achieve this outcome.

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