<b>PREVALENCE OF MATERNAL MORTALITY AND MORBIDITY IN ANTENATAL CARDIAC PATIENTS AT TERTIARY CARE HOSPITAL</b>

Background: Cardiac disease is an important indirect cause of maternal morbidity and mortality worldwide and remains a significant challenge in low- and middle-income countries. Physiological cardiovascular adaptations during pregnancy may worsen pre-existing heart disease, increasing the risk of adverse maternal outcomes. Local data regarding maternal outcomes among antenatal women with cardiac disease remain limited. Objective: To determine the prevalence of maternal mortality and maternal morbidity among antenatal patients with cardiac disease presenting to a tertiary care hospital. Methods: A hospital-based cross-sectional study was conducted in the Departments of Obstetrics and Cardiology at Jinnah Postgraduate Medical Centre (JPMC), Karachi. A total of 37 pregnant women aged 18–45 years with confirmed cardiac disease were recruited using consecutive non-probability sampling. Data were collected using a structured proforma through patient interviews and review of hospital records. Demographic characteristics, type of cardiac disease, maternal morbidity, and maternal mortality were recorded. Data were analyzed using SPSS version 25. Continuous variables were summarized as mean ± standard deviation, whereas categorical variables were presented as frequencies and percentages. Associations were assessed using the Chi-square test, with a p-value ≤0.05 considered statistically significant. Results: Thirty-seven antenatal women with cardiac disease were included in the study. Rheumatic heart disease was the most frequently identified cardiac disorder (37.8%), followed by congenital heart disease (27.0%) and peripartum cardiomyopathy (24.3%). Maternal morbidity was observed in 51.4% of participants, with heart failure being the most common complication (21.6%), followed by arrhythmias (13.5%), ICU admission (10.8%), and thromboembolic events (5.4%). Maternal mortality occurred in 8.1% of patients, while 91.9% survived until hospital discharge. Conclusion: Maternal cardiac disease remains associated with substantial maternal morbidity despite relatively low mortality in this study. Rheumatic heart disease was the predominant cardiac disorder, and heart failure was the most frequent complication. Early diagnosis, routine antenatal cardiac evaluation, timely referral, and multidisciplinary management are essential to improve maternal outcomes and reduce pregnancy-related cardiovascular complications in resource-limited settings.