MATERNAL KALP HASTALIĞI OLAN 115 GEBELİK OLGUSUNUN SONUÇLARI

Amaç: Maternal kalp hastalığı bulunan gebeliklerin sonuçlarını değerlendirmek. Gereç ve Yöntem: 2013-2018 yılları arasında bir kliniğimizdeki 115 maternal kalp hastalığı olan olgunun sonuçları retrospektif olarak incelenmiştir. Olgular değerlendirilirken kalp hastalıklarının türü ve New York Kalp Derneği’nin fonksiyonel sınıflaması göz önünde bulundurulmuştur. Bulgular: New York Kalp Derneği sınıflamasına göre hastaların dağılımı evre I için %67,1, evre II için %18,2, evre III–IV için ise %14,7 idi. Maternal ya da perinatal mortalite saptanmadı. Romatizmal ve konjenital kalp hastalıklarının görülme oranı sırasıyla %51,3 ve %27,8 olarak bulundu. Maternal morbidite 18 olguda (%15,6) gözlendi. Ortalama doğum haftası ve doğum kilosu evre I–II fonksiyonel kapasiteli grupta belirgin yüksekti (p<0,001). Maternal morbidite ve yenidoğan yoğun bakım ünitesine kabul oranları ise evre III–IV fonksiyonel kapasiteli grupta belirgin yüksekti (p<0,001). Evre I–II ve evre III–IV grupları arasında sezeryan ile doğum oranları ve fetal gelişim kısıtlılığı görülme sıklığı açısından anlamlı fark saptanmadı (p>0,05). Sonuç: Multidisipliner bir yaklaşımla yönetildiğinde kalp hastalığı bulunan gebelerin çoğunluğunda hem anne hem fetüs için memnun edici sonuçların alınması mümkündür.

Anahtar Kelimeler:

Kalp hastalığı, gebelik

PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE

Objective: To evaluate the outcomes of pregnancies with maternal heart disease. Materials and Methods: The results of 115 patients in our clinic between 2013 and 2018 were retrospectively analyzed. The type of heart disease and functional classification of the New York Heart Association were taken into consideration when evaluating the cases. Results: According to the New York Heart Association classification, the distribution of patients was 67.1% for stage I, 18.2% for stage II, and 14.7% for stage III–IV. There was no maternal or perinatal mortality. The incidence of rheumatic and congenital heart diseases was 51.3% and 27.8%, respectively. Maternal morbidity was observed in 18 cases (15.6%). Mean gestational age and birth weight were significantly higher in the stage I–II functional capacity group (p<0.001). Maternal morbidity and admission rates to neonatal intensive care unit were significantly higher in the stage III–IV functional capacity group (p<0.001). There was no significant difference between stage I–II and stage III–IV groups in terms of cesarean delivery rates and fetal growth restriction (p>0.05). Conclusion: It is possible to obtain satisfactory results for both mother and fetus in the majority of pregnant women with heart disease when managed with a multidisciplinary approac

Keywords:

Heart disease pregnancy, outcome,

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