Bengaluru Woman Defies Rheumatic Heart Disease, Delivers Healthy Baby

Pregnancy puts a substantial strain on the heart and circulatory system due to a 30% to 50% increase in blood volume, making it more difficult for women who already have heart issues.

In India, congenital heart disease and rheumatic heart disease are the two most common cardiac difficulties during pregnancy, frequently leading to major obstetric issues such as preeclampsia, anaemia, and foetal growth limits.

Dr. Varini N., senior consultant in obstetrics and gynaecology at Milan Fertility Centre in Bengaluru, provided a powerful example of persistence and medical expertise. She told the account of Mrs. Sohini (name changed), a 35-year-old woman with a history of rheumatic heart disease. Mrs. Sohini encountered continued hazards after a prosthetic heart valve replacement in 2006 to repair a blocked valve, including infection and clot formation, necessitating high-dose blood thinners.

Pointing out that the would be mother’s path to motherhood was riddled with hurdles, the treating doctors said that despite contacting fertility specialists, she got pregnant spontaneously but miscarried at ten weeks.

Following cardiology guidelines, she developed valve blockage, necessitating a second valve replacement surgery which made Mrs. Sohini's pregnancy was to be classified as high-risk because of the combined problems of preventing clots and managing bleeding risks, the doctors added.

Dr. Varini stated, "We referred her to the Milan Maternal-Foetal Medicine (MFM) department for specialised care at 10 weeks." The medical team had to carefully balance the safety of the baby with the preservation of Mrs. Sohini's heart.

Rheumatic fever causes irreversible damage to heart valves, which is the cause of rheumatic heart disease. It is a common cause of maternal cardiac problems during pregnancy, particularly in situations of untreated or undertreated childhood streptococcal infections. Women with this illness are at a higher risk of developing heart failure, having a preterm baby, or dying while pregnant.

Early symptoms include fever, joint discomfort, and weariness, but severe cases can cause chest pain, dyspnoea, and sudden cardiac arrest. Pregnancy can increase difficulties for women with untreated rheumatic heart disease, necessitating termination.

Mrs. Sohini's pregnancy highlights the complexities of managing high-risk patients. Her dependency on blood thinners created considerable complications, particularly in preventing preeclampsia and managing bleeding risks. Careful planning was required, including regular monitoring of foetal growth and maternal heart function.

An elective C-section was arranged for 37 weeks to reduce risks. Blood thinners were stopped 12 hours prior to surgery and resumed six hours later. Dr. Varini stated that they kept blood components ready to manage any unforeseen complications. The infant, weighing 2.8 kg, arrived successfully. Mrs. Sohini spent 24 hours in a high-dependency unit before being transferred to a regular ward and discharged on day four.

Both mother and kid healed well without difficulties. Mrs. Sohini expressed gratitude for the team's care, saying, "She encouraged and explained the procedure, which allowed me to relax and trust it."

Rheumatic heart disease is still the primary cause of maternal cardiac complications during childbirth around the world. Experts emphasise the necessity of early detection and treatment to avoid serious problems. Women with preexisting heart issues require multidisciplinary care from cardiologists, obstetricians, and foetal medicine specialists.

This instance emphasises the value of collaboration and precision in handling high-risk pregnancies and providing hope and motivation to women facing similar challenges.