Three of five women knew of their heart disease for the first time during pregnancy: study
The Hindu
CHENNAI
In a study of more than 1,000 pregnant women, doctors of Madras Medical College (MMC) found that three of five women had come to know of their heart disease for the first time during pregnancy. While rheumatic heart disease (RHD) was the most common, followed by congenital heart disease (CHD), the doctors observed high maternal mortality and morbidity in pregnant women with heart diseases.
Aiming to lay the basis for Indian guidelines for management of pregnant women with heart diseases, the doctors took up a study — ‘Pregnancy outcomes in women with heart disease: the Madras Medical College Pregnancy and Cardiac Registry from India”.
A total of 1,029 consecutive pregnancies in 1,005 women with heart diseases registered in the institution between July 2016 and December 2019 were prospectively followed up throughout pregnancy and post-partum. The findings of the study were published in European Heart Journal this month.
One of the key findings was the time of diagnosis of heart disease. It was diagnosed for the first time during pregnancy in 60.5% women. Most of the pregnancies involved asymptomatic or minimally symptomatic women, with some of them coming late in pregnancy — second or third trimester — with breathlessness, said one of the authors, G. Justin Paul, professor of Cardiology, MMC and State Heart Disease Nodal Officer, National Health Mission, Tamil Nadu.
“In fact, we observed a lot of social issues as well. There were instances of broken marriages and domestic violence for women with heart diseases,” he said.
The doctors found that 42.1% of the pregnancies involved RHD. Of the 433 pregnancies involving RHD, mitral valve involvement was the most common. More than one-fifth of the RHD patients had undergone prior surgical/interventional procedure before conception, of which prosthetic valve replacement (65 women) was the most common. CHD was the next largest group (33.6%) of which shunt lesions (76.3%) predominated.
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