{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T15:11:48Z","timestamp":1776093108160,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyze maternal and perinatal outcomes in women with rheumatic valvular heart disease and to evaluate the predictive factors for adverse cardiac outcomes in this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was performed of pregnant women with rheumatic heart disease (RHD) who delivered at a tertiary care referral hospital over a 5\u2010year period from 2018 to 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 118 pregnant women with RHD were encountered during the study period. The mitral valve was most commonly affected (75\/118; 62.7%), 79\/118 (66.9%) underwent cardiac interventions, and 39\/118 (33%) were on anticoagulation medication. Deterioration in New York Heart Association (NYHA) functional class was noted in 36\/118 (30.5%) of these women prenatally, and cardiac failure developed in 18\/118 (15.3%). New\u2010onset arrhythmia occurred in 6\/118 (5.1%), which was managed medically. Mean gestational age at delivery was 36.73\u2009\u00b1\u20092.53\u2009weeks, with a cesarean delivery rate of 68\/118 (57.6%). Among fetal and neonatal outcomes, average birth weight was 2390.46\u2009\u00b1\u2009574.46\u2009g, with 38\/118 (32.2%) being preterm and 61\/118 (52.5%) being low birth weight. Key predictors of poor cardiac outcomes included more than one affected valve and a poor NYHA functional class (more than II) at admission. Patients with mechanical heart valves faced higher risks from anticoagulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pregnancy in women with RHD is associated with adverse maternal cardiac, obstetrical, and neonatal outcomes. More than one affected heart valve and a poor NYHA functional class were found to be strong predictors of adverse cardiac outcomes during pregnancy. A specialized cardio\u2010obstetric team is crucial for enhancing pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70595","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T12:21:46Z","timestamp":1760617306000},"page":"172-179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive factors for adverse pregnancy outcomes in women with rheumatic valvular heart disease: A single\u2010center retrospective analysis"],"prefix":"10.1002","volume":"173","author":[{"given":"Soniya","family":"Dhiman","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. Aparna","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vatsla","family":"Dadhwal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9501-6095","authenticated-orcid":false,"given":"Akanksha","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidushi","family":"Kulshrestha","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lamk","family":"Kadiyani","sequence":"additional","affiliation":[{"name":"Department of Cardiology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richa","family":"Vatsa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juhi","family":"Bharti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maroof A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neena","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy340"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.501"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2022.104293"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0253581"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2020.09.010"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2017.11930218"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf265"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.095240"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-305597"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc3001.093437"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.076"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04259-6"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2019.1587595"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2021.01.012"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.015242"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S388754"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.5152\/AnatolJCardiol2022.1644"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1877_21"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2020-316648"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.5334\/gh.1183"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2016.04.017"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2022.100022"}],"container-title":["International Journal of Gynecology &amp; 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