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By continuing to use this website, you agree to their use. These babies had APGAR scores of 4 — 6 requiring active resuscitation in the form of bag and mask ventilation but then quickly recovered. None required chest compressions or drugs. Out of 24 cases, 16 were unoperated and 8 cases were operated for their cardiac disease with the most common surgery being CoA angioplasty.
Most of the mothers underwent Caesarean section on general anaesthesia. The type of anaesthesia did not significantly influence the neonatal outcome. Two babies had poor APGAR scores because of maternal general anaesthesia requiring bag and mask ventilation but they recovered within 5 minutes.
Mothers who were operated had slightly higher incidence of LBW, IUGR, jaundice, congenital anomalies but none were statistically significant. This relatively higher incidence of CHD as compared to other studies is seen mainly because of the study being conducted in a tertiary cardiac care centre catering to all types of cardiac diseases. Other studies had reported that MS was the predominant valvular lesion It was not as worse as was once thought due to the advances in medical field.
This LBW may probably be attributed to maternal cardiac status and the effect of cardiac risk factors as discussedsubsequently. Our observations reiterated this observation again emphasizing the contribution of maternal risk factors on the outcome. This prematurity was probably due to spontaneous onset of labour.
None of the mother — baby diagnoses was found completely concordant. This is in concordance with the hereditary transmission of CHD of probable single gene origin.
This slightly higher percentage was probably because of the smaller study population. This association of maternal and fetal CHD can be attributed to single gene autosomal dominant inheritance or multifactorial inheritance. Karyotyping was done on all babies born to mothers with bad obstetric history and those with suspected chromosomal syndromes.
Mother was not on any teratogenic drugs. Investigations revealed normal enzyme levels required in the synthesis of sex hormones and karyotyping showed normal 46XY. Another baby born to mother with truncus repair who had congenital cataract and hypocalcemia due to hypoparathyroidism was diagnosed to have chromosome 22q. Chromosome 22q Reported incidence of 22q Most of the cases are sporadic.
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There were many other outcomes like feed intolerance, metabolic disturbances, sepsis etc. Only one was born to mother with cardiac risk factor.
Cardiology at a Glance for PDA (Web Download)
Both died due to sepsis and low birth weight consistent with other studies [4,11,13]. Comparison of neonatal outcome with maternal parameters. Prior studies have focused on the risk stratification of women with cardiac disease so that they receive appropriate care and counselling [11,15]. Hemodynamic compromise secondary to valvular stenosis and the resulting decrease in uterine blood flow are probable explanations for the high incidence of impaired intrauterine fetal growth seen in this study of patients with valvular heart disease 6.
Medical Devices of the Chest
Maternal arrhythmias have been shown to cause fetal distress [6,7] and may be an additional mechanism leading to compromised uterine blood flow and fetal outcome. Maternal oxygen saturation is inversely proportional to neonatal birth weight; hence cyanosis causes increased incidence of IUGR, LBW, prematurity. Prior studies have reported even worse perinatal outcomes in those babies born to mothers with cardiac and obstetric risk factors 4 but due to our study population being small, significant derivations could not be made. In our study, there was no difference in the neonatal outcome among newborns born to mothers with RHD and CHD groups as also between mothers with cyanotic and acyanotic heart disease groups.
The reason for this could probably be attributed to the study population being low. On the contrary, earlier studies have shown that outcome in acyanotic heart disease was better than in cyanotic heart diseases The neonatal outcome was no different in those born to mothers operated and those not operated. This could partly be because of their post operative cardiac status being compromised as a result of their original high risk cardiac condition and partly because of drugs like beta blockers.
There was no evidence of any congenital malformations or bleed. Other drugs did not cause any significant adverse outcome. Cardioactive drugs including diuretics, digitalis and beta blo.
Harrison's Cardiovascular Medicine
Our study reiterated the significant association between cardiac risk factors in the mother and adverse neonatal outcome as was done earlier. Significant association was found between adverse neonatal events and cardiac risk factors in pregnant women. Fetal echo followed by neonatal echo becomes essential in case of mothers with CHD as there are high chances of fetal transmission of CHD. Thilen U and Olsson SB. Pregnancy and heart disease: a review. Braunwald E. Valvular heart disease.
New York, McGraw-Hill, — Cardiovascular disease.
In: F. Gary Cunningham Eds. Williams Obstetrics, 23rd edn. McGraw Hill publications. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation ;— Pregnancy outcomes in women with congenital heart disease. Circulation ; 4 — Cardiac disease in pregnancy. Curr Opin Obstet Gynecol ; Pregnancy outcome and mitral valve prolapse.
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