The incidence of cardiac disease in pregnancy is increasing and cardiac disease remains the leading cause of indirect maternal deaths. Management in pregnancy is highly specialised and requires early diagnosis, referral and multidisciplinary input.
The aim of this study was to assess the management and pregnancy in women with cardiac disease who were referred to the newly established obstetrics and cardiology service at a tertiary referral centre.
This is a retrospective audit of women seen in the obstetrics cardiology clinic between 2012 and 2013. Fifty cases were reviewed. The cases were identified from the cardiac cases database and multidisciplinary meeting lists. The pregnancy outcome was obtained from the electronic hospital database.
There were 30 cases of congenital and 20 of acquired heart disease with two cases newly diagnosed during pregnancy. The median age was 27 (95% CI: 26–29 years) and BMI was 24 kg/m2 (95% CI: 23–26). The median gestation at booking was 13 (95% CI: 12–14 weeks). Eight women had antenatal cardiac complications: 1 had pulmonary oedema and needed valvoplasty and 7 had arrhythmias. There were 48 livebirths with median birthweight of 3330 (95% CI: 3151–3483 grams) and median gestation at delivery of 40 weeks. Thirty-one women had vaginal delivery. Two women had preterm delivery. There was one neonatal death due to hydrops and one fetus had congenital heart disease.
This study shows that pregnancies in women with both congenital and acquired disease were managed by multidisciplinary input and the overall maternal and neonatal outcome was good.