Maternal Mortality in Pregnancy with Heart Disease

Abstract

Introduction: The incidence of heart disease complicating pregnancy is approximately 1–3% of pregnancies and is responsible for 10 to 15% of maternal mortality. While rheumatic heart disease is on real decline in western world, it is adamantly remaining unchanged here in Nepal and persistently contributing to maternal mortality in cardiac complication in pregnancy.

Methods: From the ongoing maternal mortality study since BS 2050 (13^th April 1993), data from last 15 years (April 1998 - 2013) were extracted. The data were tabulated and analyzed.

Results: There were 14 12.5% deaths accountable to heart disease in a total 112 maternal mortality during the period of 15 years and they were mostly from rheumatic heart disease. Most of them were multivalvular heart disease except for a solitary case of aortic stenosis. MTP (2) Caesarian (3) breech vaginal delivery (1) were performed and spontaneous expulsion was managed along with supportive care delivered in mothers who died shortly after admission.

Conclusion: Poor health seeking behavior and careless attitude is a part of blame game played often played whereas mortality from rheumatic heart disease which is obsolete in global scenario is of utmost concern as cardiac conditions pertaining to this etiology can be minimized certainly and the mortality attributed thus can be reduced. Termination of pregnancy should only be allowed for reason more than valvular lesion like coarctation of aorta.