[Perinatal perspective in heart disease and pregnancy. Review of 1169 cases of pregnancy].

OBJECTIVE

To determinate the effect of maternal heart disease on pregnancy outcome.

METHODS

We reviewed retrospectively 1169 pregnancies in 1093 women with heart disease. 53 women were assisted during 2 pregnancies, ten during 3 and one during 4 pregnancies. All the pregnancies were prenatal and labor assisted at the National Institute of Perinatology, México, D.F.

RESULTS

In 705 (60.30%) the heart disease was of rheumatic origin, in 387 (33.10%) congenital and the remaining were a miscellaneous group. Mitral stenosis and mitral regurgitation (42.13%) was the commonest rheumatic cardiac lesion associated with pregnancy. Ventricular septal defect was seen in the 32.81%. 124 women had a heart valve prosthesis (87 mechanical and 40 bioprosthesis [3 women with double heart valve prosthesis]). Intrauterine fetal growth retardation was the commonest complication. (7.52%) in 29 cases were present complications of heart disease in pregnancy. The abortion was present in 30 cases and intrauterine fetal death in 7 cases. There were 977 term pregnancies. The caesarean section rate was 32.5 per cent, most of them were performed for obstetric or fetal indications. The neonatal weight had a average of 2864.4 +/- 526.9 grams. There were eight maternal deaths in this series (five with congenital origin and 3 rheumatic). The incidence of low birth weight was 8.46 per cent. There were two babies born with cardiac congenital malformations.