BACKGROUND: Pre-existing medical disease constitutes one of the five major causes of maternal death in South Africa. Increasing numbers of women with heart disease reach adulthood as a result of advances in diagnoses and treatment of heart disease in childhood. OBJECTIVE: To assess the profile of cardiac disease and the maternal and fetal outcome of pregnant patients at Pretoria Academic Hospital (PAH). METHODS: A retrospective analysis was carried out on 189 pregnant cardiac patients who delivered at PAH between January 2002 and December 2005. RESULTS: Nearly 1% of all mothers who delivered at PAH had underlying cardiac disease. Most cardiac lesions were valvular disease secondary to childhood rheumatic heart disease. Pulmonary oedema was associated with the greatest morbidity and mortality. The severe morbidity rate was 11.6% and the case fatality rate 3.3%. The mean gestational age at delivery was 35 weeks; 18 (9.7%) babies were born before 34 weeks. CONCLUSION: Cardiac disease in pregnancy is associated with high morbidity and mortality rates for mothers and their babies. Multidisciplinary evaluation with discussion of risk factors, appropriate family planning and optimising of the cardiac state before conception is advised.
BACKGROUND: Pre-existing medical disease constitutes one of the five major causes of maternal death in South Africa. Increasing numbers of women with heart disease reach adulthood as a result of advances in diagnoses and treatment of heart disease in childhood. OBJECTIVE: To assess the profile of cardiac disease and the maternal and fetal outcome of pregnant patients at Pretoria Academic Hospital (PAH). METHODS: A retrospective analysis was carried out on 189 pregnant cardiac patients who delivered at PAH between January 2002 and December 2005. RESULTS: Nearly 1% of all mothers who delivered at PAH had underlying cardiac disease. Most cardiac lesions were valvular disease secondary to childhood rheumatic heart disease. Pulmonary oedema was associated with the greatest morbidity and mortality. The severe morbidity rate was 11.6% and the case fatality rate 3.3%. The mean gestational age at delivery was 35 weeks; 18 (9.7%) babies were born before 34 weeks. CONCLUSION:Cardiac disease in pregnancy is associated with high morbidity and mortality rates for mothers and their babies. Multidisciplinary evaluation with discussion of risk factors, appropriate family planning and optimising of the cardiac state before conception is advised.
Authors: Tabassum Firoz; Oier Ateka-Barrutia; Jose Antonio Rojas-Suarez; Chandrika Wijeyaratne; Eliana Castillo; Hennie Lombaard; Laura A Magee Journal: Obstet Med Date: 2015-08-27
Authors: Karen Sliwa; Liesl Zühlke; Robert Kleinloog; Anton Doubell; Iftikhar Ebrahim; Mohammed Essop; Dave Kettles; David Jankelow; Sajidah Khan; Eric Klug; Sandrine Lecour; David Marais; Martin Mpe; Mpiko Ntsekhe; Les Osrin; Francis Smit; Adriaan Snyders; Jean Paul Theron; Andrew Thornton; Ashley Chin; Nico van der Merwe; Erika Dau; Andrew Sarkin Journal: Cardiovasc J Afr Date: 2016 May/Jun Impact factor: 1.167