Termination of Pregnancy in Women With Cardiac Diseases
Nayana Gaba, Aashima Arora, Pooja Sikka, Vanita Suri, Rajesh Vijayvergiya
Abstract
Background: Cardiac diseases are an important contributor of maternal morbidity and mortality. Data regarding termination of pregnancy in women with cardiac diseases are scanty.
Aim: To analyze the indications, mode of termination, and outcomes of pregnant patients with cardiac diseases
Materials and Methods: This was a retrospective analysis of the indications, mode of termination, and outcome of pregnant patients with cardiac diseases presented to the Department of Obstetrics and Gynecology of a tertiary care center over 1 year.
Results: Overall, 16 women were analyzed (mean age: 29.4 ± 4.9 y, and mean period of gestation: 10.2 ± 4 wk). Of them, 4 (25%) had an urban background, and 12 (75%) had a rural background. Of the 16 women, 14 (87.5%) were not using any form of contraception, while 2 (12.5%) had failure of barrier method. Fourteen (87.5%) had at least 1 living child.
Furthermore, 13 (81.25%) had a previously diagnosed cardiac disease, while 3 (18.75%) had a diagnosis in the current pregnancy. Only 2 (12.5%) reported having received a very comprehensive counseling against pregnancy by a cardiologist. The diagnosis was rheumatic cardiac disease in 6 (37.5%), dilated cardiomyopathy in 4 (25%), congenital defect in 3 (18.75%), Wolff–Parkinson–White syndrome in 2 (12.5%), and primary pulmonary artery hypertension in 1 (6.25%).
Indications of termination were unwanted pregnancy in 8 (50%) and danger to maternal health in 8 (50%). The mode of termination was surgical in 11 (68.75%) and medical in 5 (31.25%). There was no mortality, and 2 (12.5%) patients had transient cardiac complications. Finally, 11 patients (68.75%) agreed to use some form of contraception after the termination of pregnancy.
Conclusion: Effective strategies are required to educate women with cardiac diseases regarding pregnancy. Formal treatment guidelines for termination of pregnancy are needed to aid in their management.
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