Use of broad consent and related procedures in genomics research: Perspectives from research participants in the Genetics of Rheumatic Heart Disease (RHDGen) study in a University Teaching Hospital in Zambia

INTRODUCTION Rheumatic heart disease (RHD) remains a major public health problem in developing countries. In low income countries RHD accounts for approximately 90% of all cardiovascular disease among pregnant women. This study aims to evaluate the prevalence and pattern of RHD among reproductive age group women presenting to a tertiary care teaching hospital in Central Nepal. MATERIAL AND METHODS Prospective observational study was carried out in College of Medical Sciences Teaching Hospital, Bharatpur, Nepal from January 2019 to December 2019 by doing transthoracic echocardiography (TTE) of reproductive age group females (n=800) from 15 years to 45 years of age. The data were collected in pre-structured proforma. RESULTS Out of 800 patients, RHD was present in 46 (5.75%) patients. The incidence of RHD was found to be highest in the age group of 30-35 years 13 (28.3%) and the mean age of presentation was 29.24 years. Mitral valve was the most common valve involvement and mitral regurgitation 37 (80.4%) was the most common valvular dysfunction present in patients with RHD. CONCLUSION The prevalence of RHD among reproductive age group female is high and mitral valve is the most commonly affected valve.

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Obstetric outcome in patients with rheumatic heart disease: experience of a tertiary hospital.

Nepalese Heart Journal ◽

10.3126/njh.v14i2.18500 ◽

2017 ◽

Vol 14 (2) ◽

pp. 31-34

Author(s):

Poonam Sharma Koirala

Keyword(s):

Heart Disease ◽

Mitral Regurgitation ◽

Rheumatic Heart Disease ◽

Mitral Stenosis ◽

Mode Of Delivery ◽

Functional Class ◽

University Teaching ◽

Cardiac Events ◽

Low Birth Weight Infants ◽

Rheumatic Heart

Background and Aims: Pregnancy in patients with rheumatic heart disease has always been challenging. Haemodynamic changes in pregnancy with diseased heart may cause adverse maternal and fetal outcome.Methods: A prospective study was done in pregnant women with rheumatic heart disease over a period of 2 years from 2015 to 2016 at Tribhuwan University Teaching Hospital, Kathmandu. Baseline data collected at antenatal period were analyzed with obstetric outcomes.Results: A total of 85 women were enrolled in this study. Sixty percent of the women were primigravida. Mitral stenosis was the commonest lesion (69.41%), followed by mitral regurgitation (25.88%) and aortic stenosis (4.71%). Cardiac events were noted in 32 patients out of which 11 developed pulmonary oedema and 6 had new onset of atrial fibrillation. Vaginal delivery (58.82%) was the commonest mode of delivery followed by cesarean section (24.7%). Eighty percent of women remained in NYHA functional class I and II, whereas 20% had deterioration of functional class. There were more maternal and fetal complications in women with NYHA III or IV in comparison to women with NYHA I or II. Low birth weight infants were found in 37.64% of cases. There was one maternal death in a lady with severe mitral stenosis with moderate mitral regurgitation due to congestive heart failure at 34 weeks of gestation. There were 8 fetal and 11 neonatal deathConclusions: Functional cardiac status during pregnancy has a major impact on maternal and fetal outcome. Rheumatic heart disease diagnosed before pregnancy may improve the outcome.Nepalese Heart Journal 2017; 14(2): 31-34

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