Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Women with congenital or acquired cardiac disease undergoing gynecologic surgery face significant peri-operative risks due to altered hemodynamics, potential for decompensation and challenges in anticoagulation management. While early series such as Wei. reported no major events in small cohorts, contemporary data in diverse cardiac populations are limited. To describe peri-operative management strategies and quantify major cardiac complication rates in 17 consecutive women with cardiac disease undergoing gynecologic procedures and to estimate the upper 95% confidence limit of these complication rates. A prospective case series was conducted from January to December 2025 at a tertiary-care center. Seventeen women $18 years with documented congenital heart defects, rheumatic or degenerative valvular disease, prosthetic valves, or ischemic heart disease scheduled for elective or emergency gynecologic surgery were enrolled. Detailed data on demographics, cardiac profile (NYHA class, echocardiography), surgical procedures, anesthesia, anticoagulation and outcomes (major cardiac events, bleeding, length of stay) were collected. Data analysis via SPSS v25 included descriptive statistics, Clopper-Pearson confidence intervals for complication rates, Fisher’s exact test and Mann-Whitney U tests for subgroup comparisons. No major cardiac complications occurred (0/17; upper 95% CI 18%). One patient experienced significant bleeding (6%, 95% CI 0.2-28%). The median length of stay was 4 days (IQR 3-6). NYHA class III patients had a longer median stay than class I-II (6 vs. 3 days, p = 0.045). Thirty-day mortality was 0%. In this exploratory series, gynecologic procedures were safely performed in women with significant cardiac disease under a structured multidisciplinary protocol. Observing no major events in 17 patients supports feasibility, although larger studies are needed to refine risk estimates.
How to cite this article:
Deeksha Pandey and Ann Baby. Gynecologic Interventions in Women with Congenital and Acquired Heart Conditions: A Prospective Analysis.
DOI: https://doi.org/10.36478/makrjms.2024.12.803.806
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2024.12.803.806