Anaemic heart failure in labour; management protocols

ABSTRACT

To define accurate management protocols for better outcome in patients of anaemic heart failure during labour. DESIGN: Prospective study. PLACE AND DURATION OF STUDY Obstetrics and Gynaecology Unit II of Bahawal Victoria Hospital, Bahawalpur from January 2000 - December 2001. PATIENTS AND METHODS: Patients were randomly selected from outdoor and emergency department. Referred patients from other units were also included. Record of patient's age, parity, haemoglobin percentage, severity and sign / symptoms of cardiac failure were noted. 34 patients with anaemic heart failure were included in this study. Most common complication found was pulmonary oedema [29.41%]. It was found that 61.76% [21] patients had haemoglobin percentage between 4 - 5gm% and occurrence of cardiac failure was common with the parity 6 -10 [41.17%] births. Mostly the patients with anaemic heart failure were between 31 - 40 years of age [41.24%].29 [85.3%] out of 34 foetuses were delivered alive. Three patients died due to cardiac arrest and pulmonary oedema so, the maternal mortality was 8.82% in this study. Anaemic heart failure and maternal mortality can be prevented if simple frusimide ferrous sulphate tablets are advised during period, supported with ionotropic drugs like digoxin etc. Active management protocol should be observed for delivering such patients