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Published on: May 5, 2018
Cardiac disease in pregnancy
T Nqayana1, J Moodley, D P Naidoo
1Department of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Cardiovascular Journal of Africa
|June 24, 2008
Summary
Cardiac disease in pregnancy poses significant risks, leading to high maternal morbidity and adverse fetal outcomes, particularly in developing nations. Early clinical assessment and timely interventions are crucial for improving patient and infant health.
Area of Science:
- Cardiology
- Obstetrics
- Maternal-Fetal Medicine
- Public Health in Developing Countries
Background:
- Cardiac disease is a critical concern in pregnancy, especially in developing countries where resources may be limited.
- Understanding the specific challenges and outcomes of cardiac disease in pregnant populations is essential for improving care.
- Rheumatic heart disease is a prevalent etiology impacting maternal and fetal health during gestation.
Purpose of the Study:
- To retrospectively review patient charts of pregnant women with cardiac disease in a developing country.
- To identify common etiologies, interventions, maternal morbidity, and fetal outcomes.
- To highlight the impact of presentation timing and anticoagulation management on outcomes.
Main Methods:
- Retrospective chart review of 95 patients with cardiac disease during pregnancy.
- Analysis of patient demographics, cardiac etiologies, interventions (e.g., balloon mitral valvuloplasty, valve replacement), and management.
- Evaluation of maternal morbidity (cardiac failure, atrial fibrillation, intensive care unit admission) and fetal outcomes (live births).
Main Results:
- The majority of patients (36/95) were aged 21-25 years.
- Rheumatic heart disease was the most common cause; 8 women underwent balloon mitral valvuloplasty, and 1 had valve replacement.
- No maternal deaths occurred, but maternal morbidity was high (13 cardiac failures, 9 atrial fibrillation, 3 ICU admissions). 86 live births from 97 deliveries were recorded.
Conclusions:
- Cardiac disease in pregnancy is linked to substantial maternal morbidity and adverse fetal outcomes, often exacerbated by late presentation.
- Challenges in anticoagulation management contribute to poor outcomes.
- Emphasizes the critical role of clinical assessment for timely referral and appropriate investigations in managing cardiac disease during pregnancy.
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