Maternal and Fetal outcomes following open heart surgery during pregnancy

ABSTRACT

This study is aimed at evaluation fetal and maternal outcome in pregnant women with heart disease candidate for open heart surgery. In this study we evaluated adverse complications in 14 pregnant women underwent open heart surgery during three years period. Variable parameters were age, parity; gestational age, history of cardiac surgery and medications, cardiac complications during pregnancy surgical indications of cardiac disease, fetal and maternal mortality and related complications. Mean age and gestational age were 38.4 years and 17.28 weeks respectively. Most of the patients were multiparous [71.42%] and in functional NYHA class III or IV [85.70%]. During pregnancy 71.43 percent of patients showed signs and symptoms of CHF and 64.28 percent of them had atrial fibrillation. All patients underwent emergent open heart surgery. Maternal and fetal mortality following surgery were 35.71 and 78/57 percent respectively. Cardiac Surgery during pregnancy were accompanied with high fetal and maternal mortality. Such pregnancies need to be managed by a team including obstetrician, cardiologist, anesthetist and cardiac surgeon. For best result, it is better to postpone surgery whenever possible and surgery is performed only when it was indicated. The present study demonstrates that emergency surgery, poor NYHA class, Atrial Fibrilation, unstable heart disease, poor economical cultural conditions will result in adverse outcome in mother and fetus following cardiac surgery