Pregnancy outcome in women with heart disease undergoing induction of labour

Objective: To examine the safety and outcome of induction of labour in women with heart disease. Design: Prospective single-centre comparative study. Setting: Major university-based medical centre. Population/Sample: One hundred and twenty-one pregnant women with heart disease. Methods: The sample included all women with acquired or congenital heart disease who attended our High-Risk Pregnancy Outpatient Clinic from 1995 to 2001. The files were reviewed for baseline data, cardiac and obstetric history, course of pregnancy and induction of labour and outcome of pregnancy. Findings were compared between women who underwent induction of labour and those who did not. Forty-seven healthy women in whom labour was induced for obstetric reasons served as controls. Main outcome measures: Pregnancy outcome. Results: Of the 121 women with heart disease, 47 (39%) underwent induction of labour. There was no difference in the caesarean delivery rate after induction of labour between the women with heart disease (21%) and the healthy controls (19%). Although the women with heart disease had a higher rate of maternal and neonatal complications than controls (17% vs 2%, P = 0.015), within the study group, there was no difference in complication rate between the patients who did and did not undergo induction of labour. Conclusion: Induction of labour is a relatively safe procedure in women with cardiac disease. It is not associated with a higher rate of caesarean delivery than in healthy women undergoing induction of labour for obstetric indications, or with more maternal and neonatal complications than in women with a milder form of cardiac disease and spontaneous labour.