Rheumatic cardiac disease in pregnancy. Long-term followup

All but 3 of 263 women with confirmed rheumatic cardiac disease seen during pregnancy in the 5-year period, July 1937 to August 1942, have been traced up to 1974. The series was enlarged by including all the cases (57) in functional Classes III and IV at conception which were seen from 1931 through 1943; all have been traced. The remote mortalities have been: in patients Class I at conception, 58.3% dead (with an average annual death rate of 23.5/1000); Class II at conception, 73.8% dead (average annual death rate 36.5/1000); Classes III and IV at conception, 91.3% dead (average annual death rate, 66.5/1000). A comparison of women with and without pregnancies subsequent to the one admitting them to the study fails to show any remote adverse effect of later pregnancies of the course of the disease.