Impact of Elective Abortion in pregnancy with Cardiac problems

Abstract

Introduction: Pregnant women with heart diseases advance either to preterm/term delivery. Some of the pregnancies end in abortions, which however are spontaneous or are terminated for medical reasons.

Method: Retrospective study done in the Department of Obstetrics and Gynecology at Tribhuvan University Teaching Hospital from April 2010 to March 2011 (Baisakh 2067 to Chaitra 2067); Source of data was Operation Theater Register and Admission files.

Results: MTP were done for altogether 18 cases of heart diseasesin pregnancy. Primigravida (6) and multigravida (12) were seen in age groups 20-30 (13); 30-40 (5) at gestational weeks of 6-8 (n=10); 9-10 (n=6); 11-12 (n=1); >12 (n=1). The heart diseases were {CHD (1); rest 17 RHD: Majority being done following post valve replacement surgery 11[AVR (1); DVR (3) & MVR (7)]}. Latter mandated a tedious process of anticoagulation, switching from heparin to warfarin and vice versa demanding prolonged hospitalization (up to 12 days) as co- morbidity. Mainly because repeat MVA was needed for incomplete abortion as complication in one case, subsequent procedures were done under USG guidance.

Conclusion: It is simpler and safer to avoid pregnancy in heart diseases; especially in those women with post valve replacement surgery rather than imposing MTP, the procedure concerned are not without associated risk, beyond doubt.