LABOUR ANALGESIA AND PREGNANCY OUTCOME IN CARDIAC DISEASE COMPLICATING PREGNANCY.
DOI:
https://doi.org/10.48047/Keywords:
Cardiac disease complicating pregnancy, Labour Analgesia, Epidural anesthesia, Instrumental delivery , Arrhythmia, Labour maternal morbidity and mortality.Abstract
Background: Pregnancy makes a significant demand on the cardiovascular system. Cardiac disease is the most common cause of mortality in pregnancy. Cardiac disease has the potential to remain undiagnosed; it may present with cardiovascular decompensation during pregnancy, at the time of delivery, or immediately post-partum. The main aim is early risk assessment, optimization, regular monitoring for deterioration, planning of delivery, and surveillance for deterioration in the immediate post-partum period. One of the most severe pain experienced by a woman is during child birth. Hence, relief of labour and child birth pain, including cesarean delivery is essential. Objective of this study: To assess the impact of labour analgesia and the pregnancy outcome and cardiac events during labour. It is important to understand the pain transmission for providing labour analgesia. Hemodynamic status fluctuates greatly during labour. Therefore, pregnant women with cardiovascular disease need epidural anaesthesia during labour depending upon the type of cardiovascular disease. Methodology: This is a prospective observational study conducted at Sree Mookambika institute of medical sciences in 50 antenatal women with cardiac disease complicating pregnancy during the period of June 2022 to May 2024 (2 years). Results: A total of 50 antenatal women with cardiovascular disease admitted in the department of obstetrics and gynaecology over a period of two year out of which 30 patients had epidural analgesia during labour and 20 patients had no epidural analgesia during labour. Cardiovascular events significantly reduced in epidural group (30 patients) and there was no increase in cesarean section in epidural group. Conclusions: There was significant decrease in cardiovascular events related to arrhythmia hence decreased maternal morbidity and mortality. There was no associated increase in cesarean section rate but slight increase in instrumental vaginal delivery.
