Patients with organic hea disease in pregnancy most commonly die during
Correct Answer: Soon following delivery
Description: Maternal moality in Hea disease complicatin Pregnancy Maternal moality is lowest with rheumatic hea lesions and acyanotic group of hea diseases ie <1% With the elevation of pulmonary vascular resistance especially with cyanotic hea diseases the moality may be raised to 50%( Eisenmengers syndrome) Most of the deaths occur due to cardiac failure and maximum deaths occurs following bih. Management Of Cardiac Failure: The principle if management is same as in the non-pregnant women. A cardiologist should be involved Propped up position O2 Adminstration Monitoring with ECG and pulse oximetry Diuretic: Frusemide (40-80mg) IV - Anticipatory aggresive diuresis is needed to avoid pulmonary congestion. Mechanical Ventilation Injection morphine 15mg IM Digoxin 0.5mg IM followed by Tab.Digoxin 0.25mg P/O Dysrhythmias -Quinidine or electrica cardiaversion Tachyarhymias -Adenosine(3-12mg) IV or DC conversion. Reference: D.C.Dutta's Textbook of Obstetrics; 9th edition; Page no: 258 & 260
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Gynaecology & Obstetrics
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