Tumor necrosis factor (TNF)-α-308 gene polymorphism in Indian patients with Takayasu's arteritis

Background: Cardiac disease in pregnancy presents a great challenge since it includes both cardiovascular and maternal-fetal management.The incidence of pregnancy in women with cardiovascular disease is rising and pregnancy in women with cardiac diseases still continues to be high risk pregnancy since it influences the maternal and fetal outcome.An interesting inference, which we observed during our study, is that a great percentage of asymptomatic and symptomatic cardiac diseases are first diagnosed only during pregnancy.Thus we would like to throw light on importance of cardiac assessment during pregnancy and the need for pre pregnancy counseling in patients with heart diseases.Methods: Our institution screened an estimated 4500 antenatal mothers for cardiac evaluation through January 2016 to July 2017.We carried out a prospective analysis of 403 pregnant women with known or newly diagnosed heart disease who presented to our institute between the periods of 2016 and 2017.We followed up the patients through pregnancy.Results: In our study, the incidence of cardiac disease was 0.8%.Among acquired heart disease, the still most common cardiac illness is rheumatic heart disorder (RHD) observed in 198 (48.7%) patients.Among the congenital heart disease patients the most common heart disease was atrial septal defect (ASD) 72 (17.7%).Severe pulmonary hypertension (PHT) was seen in 10.5%.Maternal mortality was 0.7% with 3 maternal deaths encountered and death was due to cardiogenic shock (RHD/Ischemic cardiomyopathy/prosthetic valve thrombosis).Fetal outcome is overall better in women with cardiac diseases with successful in 93.5% and fetal loss and perinatal mortality seen in 6.5%.Conclusion: Heart disease in pregnancy is a high-risk condition and has a major impact on pregnancy outcome.Rheumatic heart disease is still the prominent cardiac lesion.Fetomaternal mortality and morbidity can be reduced with proper antenatal, intrapartum and postnatal care in conjunction with cardiologist, gynecologist and neonatologist.

Abstract licence: CC BY-NC-ND

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