PubMed1979
Reported in this paper are 115 childbirths of 98 women with concomitant cardiac defect hospitalised in the Obstetric Department of the Regional Hospital of Karl-Marx-Stadt, GDR. Coincidence of childbirth and defect accounted for 0.3 per cent, with mitral faults clearly taking first position with 40 per cent. Forty-seven per cent of the defects were congenital. The cases were subdivided by severity according to the N.Y.H.A. scale, with 76 per cent coming under State I, 19 under State II, and only five under State III.--Spontaneous births occurred in 56 per cent, while 27 per cent were forceps deliveries and 13 per cent caesarean sections, but no section performed for purely cardiac indications. No remarkable complications were experienced intra-operatively nor postoperatively. Five per cent (five cases) of all vaginal deliveries had to be completed by vaginal extraction for cardiovascular complications, including three cases of cardiac defects in State III.--No peripartum loss of cardiac patients was recorded. Two patients with State III mitral defects, however, died of aggravating cardiovascular decompensation, five or six years after delivery. Perinatal mortality was as low as 0.8 per cent. Premature births accounted for 13.6 per cent, while hypotrophic infants were found in 6.8 per cent of the cases under review.--The above findings and their implications are discussed and conclusions drawn for obstetric practice, with some emphasis being laid on programmed delivery as the optional method, more generous indication of primary section for State III cardiac defects, and long-term aftercare in the context of internal medicine.