Cardiac Disease during Pregnancy: Nursing Management

Abstract

 The physiological changes during pregnancy place a considerable load on the heart and the cardiovascular system. Cardiac disease is an important cause of maternal mortality and morbidity in antepartum and postpartum period. Pregnancy and labour inevitably increase the cardiac strain and any complication will further add to this burden. The ratio between the two has fallen over the past two decades from 10:1 to about 3:1 or even 1:1 in advanced countries. Among all types of heart disease 80% is occupied by rheumatic heart disease with mitral stenosis in pregnancy (Dutta, 2008). In Nepal maternal death is caused due to heart disease din not even features in 1998 but in 2008/ 2009, 69 % of maternal death due to direct cause and 31% deaths are due to indirect cause. In indirect cause death due to heart disease occupies 7% (Family health division, 2008/2009). Nurses those are working in the field of maternity should manage the pregnant women having heart disease. Management must be started from preconception and continue till postnatal period. Focus must be given on early detection, grading, diet, weight gain, prevention and treatment of infection, rest, assessment of respiration, heart rate, hospital delivery, position, pain management, prevention of cardiac failure, fluid restriction, active management of third stage of labour, critical emphasis must be given within 24 hours for the prevention of cardiac failure and follow up.