scholarly journals CARDIAC MATERNAL MORTALITY IN THE DEVELOPING WORLD: SCREENING PREGNANT WOMEN IN HYDERABAD, INDIA FOR STRUCTURAL HEART DISEASE

2021 ◽  
Vol 77 (18) ◽  
pp. 3391
Author(s):  
Amisha Patel ◽  
Lauren Ranard ◽  
Nicole Aranoff ◽  
A. Harika Manga ◽  
Susheel Kodali ◽  
...  
Keyword(s):  
Heart Disease ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Developing World ◽  
Structural Heart Disease

scholarly journals Use of Routine Echocardiographic Screening for Structural Heart Disease in At-Risk Pregnant Women in India

2020 ◽  
Author(s):  
Amisha Patel ◽  
Lauren S. Ranard ◽  
Nicole Aranoff ◽  
Hussein Rahim ◽  
Roja Vanukuru ◽  
...  
Keyword(s):  
At Risk ◽  
Heart Disease ◽  
Pregnant Women ◽  
Structural Heart Disease ◽  
Women In India

Cardiovascular outcomes of pregnancy in Turner syndrome

Heart ◽  
2020 ◽  
Vol 107 (1) ◽  
pp. 61-66
Author(s):  
Jasmine Grewal ◽  
Anne Marie Valente ◽  
Alexander C Egbe ◽  
Fred M Wu ◽  
Eric V Krieger ◽  
...  
Keyword(s):  
Heart Disease ◽  
Aortic Dissection ◽  
Pregnant Women ◽  
Turner Syndrome ◽  
Structural Heart Disease ◽  
Risk Category ◽  
Hypertensive Disorder ◽  
Time Period ◽  
Increased Risk ◽  
American Society

ObjectivesWomen with Turner syndrome (TS) are frequently counselled against pregnancy due to lack of data and unclear aortic dissection risk. However, with advances in fertility therapy, more women with TS are contemplating pregnancy. This study compared rates of adverse cardiovascular (CV) outcomes among: (1) pregnant and non-pregnant women with TS and (2) pregnant women with TS with/without structural heart disease.MethodsRetrospective analysis of pregnant and age-matched non-pregnant controls with TS (2005–2017) across 10 CV centres was done. Data were collected at initial evaluation in pregnancy and outcomes were assessed to 6 months postpartum. Adverse CV events were defined as CV death, aortic dissection/rupture and/or aortic intervention. Non-pregnant age-matched controls were followed over the same time period.ResultsSixty-eight pregnancies were included (60 women, mean age 33 years, 48% primigravid, 49% fertility therapy, 80% structurally normal heart, 25% XO karyotype). Based on American Society of Reproductive Medicine criteria, 10 pregnancies occurred in women stratified to high-risk category. There were no CV events in the pregnant women or in the non-pregnant women with TS. Obstetric events complicated 12 (18%) pregnancies with 9 (13%) attributed to hypertensive disorder of pregnancy. Fetal events included small for gestational age neonates (18%), preterm delivery (15%) and fetal death (3%).ConclusionsThis study helps to refine the approach to pregnancy in women with TS. Among women with TS without structural heart disease, pregnancy does not impose an increased risk of CV outcomes. Among women with TS with structural heart disease, the risk of pregnancy is not as prohibitive as previously described but does require ongoing evaluation.

scholarly journals Characteristic of Pregnancy in Woman with Rheumatic Mitral Stenosis in Dr. Soetomo Hospital Surabaya from 2015 – 2017

2021 ◽  
Vol 2 (1) ◽  
pp. 1-7
Author(s):  
Joseph Relmasira ◽  
Budi Wicaksono
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Gestational Age ◽  
Mitral Stenosis ◽  
Perinatal Outcome ◽  
Class Iii ◽  
Rheumatic Mitral Stenosis ◽  
Rheumatic Heart

Background: Cardiac disease is 1 of the major causes of maternal mortality. Mitral Stenosis (MS) is a particularly high-risk condition for a pregnant woman in emerging countries, the main cause of MS is a complication from rheumatic heart disease. Objective: To study the maternal and perinatal outcome of pregnancies complicated by mitral stenosis from rheumatic heart disease. Methods: We conduct a cross-sectional retrospective study using electronic medical data records in dr. Soetomo General Hospital over the period of 3 years from 2015 – 2017 involving 36 cases of pregnant women complicated by rheumatic mitral stenosis. The maternal and perinatal outcome was reviewed. Result: Most of the pregnant women with rheumatic mitral stenosis were at 29 - 34 weeks of gestational age. Majority of the patient (61,1 %) was in NYHA II classification for heart failure degree. The Degree of MS was moderate (75 %) and severe (25 %), with a maternal mortality rate was 4/36 patients (11,1 %), and all of the patients were with severe MS had class III/IV heart failure. The main reason for hospital admission was heart failure (50 %). 38 % of women with NYHA Class III/IV had severe MS. Most accompanying valve diseases occur at the patient with severe MS, with Tricuspid Regurgitation as the most accompanying valve disease (66,67 %) followed by Mitral Regurgitation (36,11 %) and Aortic Regurgitation (25 %). Percutaneous Transmitral Valve Commissurotomy (PTMC) was the chosen surgical intervention for valve correction. For a patient with Moderate MS, 6/8 (75 %) of the pregnancy terminated at ³ 34 weeks of gestational age, compared with 18/28 (64,28 %) patient with Severe MS the pregnancy terminated at < 34 weeks of gestational age. Cesarean section was the most chosen method of delivery for most of the cases. Fetal weight (4/7 cases) at delivery for Moderate MS was > 2500 g, compared with (7/18 cases) was < 2000 g for Severe MS. APGAR Score for Moderate MS cases was 8-10 for 5/7 cases, compared with Severe MS, 16/24 cases were < 8. Conclusions: Cardiac and obstetric complications from rheumatic mitral disease remain a major challenge in this disease. Early diagnosis and management with good adherent to pre-conceptional and prenatal care remain a key factor for preventing maternal and fetal morbidity and mortality.

Assessment of the right ventricle in pregnant women with and without structural heart disease

2013 ◽  
Vol 168 (3) ◽  
pp. 3087 ◽  
Author(s):  
Jérôme Cornette ◽  
Titia P.E. Ruys ◽  
Jolien W. Roos-Hesselink
Keyword(s):  
Heart Disease ◽  
Right Ventricle ◽  
Pregnant Women ◽  
Structural Heart Disease ◽  
The Right

scholarly journals A protocol study of participatory action research: integrated care pathway for pregnant women with heart disease in Indonesia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Suryani Yuliyanti ◽  
Adi Utarini ◽  
Laksono Trisnantoro
Keyword(s):  
Health Care ◽  
Heart Disease ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Integrated Care ◽  
Health Care Services ◽  
Heart Diseases ◽  
Service Planning ◽  
Participatory Action ◽  
Care Services

Abstract Background Heart diseases are increasingly identified as an important indirect cause of maternal mortality in several cities in Indonesia. The management of pregnancy with heart diseases requires a multidisciplinary approach, and interprofessional collaboration practice (IPCP) is critical to improving the quality of patient care. To enable the effective implementation of IPCP, integrated care pathways (ICPs) are needed to define the roles and responsibilities of the health professionals involved. This study aims to examine the obstacles and enabling factors of IPCP, to develop and use ICPs in the implementation of IPCP in health care services for pregnant women with heart diseases. Methods A participatory action study consisting of four stages (diagnostic, planning, implementation, and evaluation) will take approximately 2 years after consensus of ICPs are made. The primary data collection process will employ consensus, observations, focus group discussions, and in-depth interviews throughout the four stages, while secondary data from referral documents and medical records will be collected mainly during the diagnostic and evaluation stages. The findings are being analysed and will then be used to develop an ICPs through consensus building at the planning stage to be applied in the implementation stage. Finally, the implementation outcome, including acceptability, adoption, appropriateness, and feasibility of IPCP, will be assessed in the evaluation stage. All qualitative data will be analysed thematically by two coders using NVIVO 12 software. Discussion This research aims to assess the needs of IPCP, develop and use the ICPs in the implementation of IPCP in health care services for pregnant women with heart diseases. Findings from this study will be used for health service planning and policy making to strengthen practice of IPCP during the referral process. As a result, pregnant women with heart disease will have better access to high-quality services at every health care facility to reduce maternal mortality. Trial registration Retrospectively registered in the ISRCTN registry with study ID ISRCTN82300061 on Feb 6, 2019.

CARDIAC ARRHYTHMIAS DURING PREGNANCY: A CLINICAL APPROACH

2011 ◽  
Vol 22 (2) ◽  
pp. 123-143 ◽  
Author(s):  
ZACHARY LAKSMAN ◽  
LOUISE HARRIS ◽  
CANDICE K SILVERSIDES
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Cardiac Disease ◽  
Cardiac Arrhythmias ◽  
De Novo ◽  
Structural Heart Disease ◽  
Clinical Approach ◽  
History Of ◽  
In Pregnancy

Physiologic changes in maternal haemodynamics, hormones and autonomic properties contribute to arrhythmias in pregnancy. While arrhythmias most commonly occur in pregnant women with structural heart disease or those with a history of cardiac arrhythmias, they can also occur de novo in women with no documented cardiac disease.

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