European Journal of Molecular & Clinical Medicine

Heart disease is a major cause of maternal mortality and morbidity during both the
antepartum and postpartum periods. Heart disease occurs less frequently than 1% of the time during pregnancy. Cardiovascular disorders complicate about 1% of all pregnancies.A thorough evaluation of the patient throughout the entire pregnancy may result in the early detection of heart disease. So, the present study was conducted with an aim to assess the effect of heart disease in pregnancy and its outcome.
Methods: This study was a cross-sectional study of the maternal-fetal outcomes of cardiac disease-related pregnancies over the last five years that were followed at tertiary care hospitals in North India. The study was carried out for three months after receiving institutional review board ethical approval. The study comprised pregnant patient files with pre-existing or newly diagnosed heart illness during pregnancy. Maternal age, parity,York Heart Association (NYHA) functional class, and materno-fetal outcome were among the variables that were recorded. The collected data was entered in the MS excel sheet. The variables were presented as frequency and percentages.
Results: In our study, a prevalence of 1.5% of heart disease was observed among pregnant women. Four fifth of pregnant women (80.0%) with heart disease were primigravida.Among enrolled pregnant women four fifth of the women were having rheumatic heart disease (84.2%). Among pregnant women with rheumatic heart disease (RHD), the single valvular lesions were seen in 28.7% of pregnant women (20.3% of mitral stenosis and 5.1% of mitral regurgitation).52.9% of pregnant women were having grade II functional class as per NYHA. Congestive cardiac failure as complication was observed in 15.7% of pregnant women. Among alive neonates, 29.2% of neonates were preterm, and 7.7% of neonates were having IUGR, 15.4% needed NICU admission
Conclusion: In underdeveloped nations, maternal and perinatal morbidity from rheumatic heart disease is high and accounts for a large portion of cardiac disease in pregnancy. When congenital heart disease is treated early in life, morbidity and mortality are reduced.

Background:The aim is to compare the spot urine protein/creatinine ratio with 24hour
urinary protein in hypertensive disorders of pregnancy.
Materials and Methods: A prospective correlational study was conducted on 100
hypertensive pregnantwomen during the study period. The objective of the study was to
know if a spot protein/creatinine ratio would provide an accurate quantification of
proteinuria and whether it can replace the use of the 24 hours urine protein in
preeclamptic women. Ethical clearance and informed consent were obtained. Urine
samples were collected for visual dipstick, spot urine P/C ratio and 24hours urinary
protein estimation.
Results: A fair degree of correlation existed between the two variables with r =
0.842with a highly significant p value <0.01 when all the observations were considered.
The correlation at lower level of proteinuria was less r = 0.72 compared to higher levels
of proteinuria,but is statistically significant. The area under the ROC curve - 0.739
(95% CI: 0.628, 0.849) with p value < 0.01 (significant). The optimal cut off point was
0.5, which yielded a sensitivity of 92% and specificity - 66%. Even though the results
were known to clinicians the values were not taken for clinical decision, only by the
ratio alone. However the 24 hour urine protein values were considered for the patient
management. The perinatal outcome in women with higher levels of proteinuria were
poor with increased incidences of IUGR, prematurity, low birth weight and the need for
NICU care was increased in such babies.
Conclusion: The present study indicates that this method for quantification of
proteinuria, when properly interpreted, can provide valuable information, that for
clinical purposes is a satisfactory substitute for the determination of protein excretion in
a 24 hour collection.