1.Clinical outcomes of Gravidocardiac patients in Silliman University Medical Center from January 2015 to December 2019: A retrospective study
Johanna Lei D. Bandoy ; Rizza Monique V. Tan-Maxino ; Antonette H. Calinawagan ; Brian Joseph M. Calinawagan
Philippine Journal of Internal Medicine 2024;62(1):295-299
Background:
Cardiac disease increases morbidity and mortality in pregnant patients. This is found in both developing
countries and underdeveloped countries. Cardiovascular demand increases with pregnancy, causing additional stress on
a diseased heart. This then poses a greater risk of complications; thus, specialized care involving an Obstetric-Gynecologist
and a Cardiologist is warranted.
The Modified WHO Classification of Maternal Cardiovascular Risk, CARPREG, and CARPREG II predict risk among
gravidocardiac patients and corresponding needed medical attention perinatally. Little data has been known on the clinical
outcomes of pregnancy among gravidocardiac patients in the Philippines. This study aims to gauge the clinical outcomes of gravidocardiac patients admitted to a tertiary hospital in Dumaguete City.
Methods:
A retrospective, cross-sectional descriptive study was carried out among all gravidocardiac patients admitted for
labor and delivery between January 2015 and December 2019. A chart review of the cases satisfying the inclusion criteria
was done. Data gathered were tabulated, and a Chi-Square was used to assess if there was a significant relationship
between the cardiac condition and the mode of delivery, duration of pregnancy, maternal outcomes, and fetal outcomes.
Results:
Cardiac lesions noted among gravidocardiac patients include mitral valve prolapse, which comprised the majority
of cases, patent ductus arteriosus, ventricular septal defect, mitral valve regurgitation, aortic valve regurgitation, atrial septal
defect, and peripartum cardiomyopathy. Pregnancies were mainly carried to term with vaginal delivery as the primary mode
of birth. Maternal outcomes were generally favorable, with no deaths recorded. Fetal outcomes were variable among cases,
and fetal mortality was recorded at 3.92%. A significant relationship was seen between maternal cardiac condition and
maternal outcomes of the pregnancies.
Conclusion
Among pregnant patients with cardiac conditions, maternal outcomes of pregnancy can be predicted in
association with the cardiac condition. There is a great need to educate the public on the need for proper perinatal care
when a cardiac condition in pregnancy is detected.