Highest maternal mortality is seen in following congenital heart disease
Correct Answer: Eisenmenger's syndrome
Description: Ans. is 'a' i.e. Eisenmenger syndrome This syndrome is secondary pulmonary hypertension that can develop with any cardiac lesion in which pulmonary vascular resistance becomes greater than the systemic vascular resistance and there should also be some right to left shunting. The most common underlying defects are atrial or ventricular septal defects and persistent ductus arteriosus.Patients usually are asymptomatic but eventually pulmonary hypertension becomes severe enough to cause right to left shunting.The prognosis for pregnancy depends upon the severity of pulmonary hypertension.The mortality rate in Eisenmenger's syndrome is 50%. It is the maximum mortality for any cardiovascular disorder in pregnancy. So termination of pregnancy is done in most cases.Maternal tolerance to specific heart conditions;Well toleratedPulmonary stenosisAortic insufficiencyMitral insufficiencyCongenital heart blockWell tolerated if pulmonary hypertension is not presentAtrial septal defectsVentricular septal defectsPatent ductusVariable tolerance depending on the functional capacity of the heartUncomplicated Aortic coarctationAortic stenosisMitral regurgitationAortic regurgitationPoorly tolerated and source of significant problems during pregnancyMitral stenosisPeripartum cardiomyopathyPrimary pulmonary hypertensionEisenmenger's syndromeMarfan's syndrome with dilated aortic rootMetallic valve prosthesisCongenital cyanotic heart diseaseConditions listed in group C if pulmonary hypertension is present.Any class III or IV lesion.
Category:
Gynaecology & Obstetrics
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