Abstract :
Pregnancy with cardiac disease is a high-risk condition with potential for serious maternal and fetal complications. The physiological changes during pregnancy, such as the increase in blood volume, cardiac output, and heart rate, can exacerbate the underlying cardiac condition, increasing the risk of heart failure, pulmonary edema, arrhythmias, and other adverse events. Because of these physiological changes and when patients are asymptomatic clinical diagnosis may be missed. Due to missing and delay in diagnosis in antenatal period we can not provide proper management during labor and postnatally, potentially leading to devastating consequences for both the mother and the fetus. This case report describes a 34-year-old G2P1L1 with undiagnosed heart disease like mitral stenosis who presented to the hospital with preterm labor, intrauterine growth restriction (IUGR), and oligohydramnios. Her pregnancy was not registered in our hospital but she was receiving antenatal care in PHC. She delivered a preterm male neonate via spontaneous vaginal delivery. However, shortly after delivery, she became breathless and was shifted to ICU. On 2D ECHO examination she was diagnosed with severe mitral stenosis, moderate mitral regurgitation, severe pulmonary arterial hypertension, and other valvular abnormalities. Despite resuscitative efforts, the patient could not be revived.In this case in spite of having many severe valvular lesions, the patient was totally asymptomatic till delivery and past medical history was also not significant so diagnosis was missed and patient landed up in severe cardiac complications. So this tragically highlights the critical need for regular antenatal care and routine 2D ECHO examination during first visit or any time during the antenatal period to facilitate the early detection and management of cardiac conditions in pregnancy. A multidisciplinary approach involving cardiologists and obstetricians is vital for improving maternal and fetal outcomes in such high-risk pregnancies.
Keyword :
Heart disease, Mitral valve stenosis, Heart failure, Pregnancy complications and maternal mortality.