Pregnancy outcomes in women with heart disease at the Colonial War Memorial Hospital, Suva, Fiji.

2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Litia Narube ◽  
James Fong ◽  
Tom Parks ◽  
Alec Joseph Ekeroma ◽  
Ilisapeci Kubuabola
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Case Fatality ◽  
Morbidity And Mortality ◽  
Memorial Hospital ◽  
Cardiac Lesion ◽  
Heart Lesion ◽  
Cardiac Lesions ◽  
Rheumatic Heart ◽  
In Pregnancy

<div><p><strong>Background: </strong>Cardiac disease in pregnancy is the third most common cause of maternal mortality in Fiji. The aim of this study was to determine the characteristics of pregnant women with heart disease presenting to the Colonial War Memorial Hospital (CWMH).</p><p><strong>Method: </strong>A retrospective review of case notes of all pregnant women identified with heart disease who birthed in the hospital between January 2011 and December 2013 (36 months).   </p><p><strong>Findings: </strong>Of the 24,844 livebirths in CWMH during the study period, 153 women, aged 15 to 43 years of age, were confirmed with a cardiac lesion, which gives a prevalence rate of 6.2 per 1,000 livebirths. Rheumatic heart disease was the commonest cardiac lesion (112, 90%) followed by congenital heart disease (6, 5%) and hypertensive cardiomyopathy (3, 2%).  Most of the cardiac lesions (120, 73%) were detected during pregnancy.</p><p>There was a higher rate of intervention, morbidity and mortality associated with a cardiac lesion. The rate of instrumental deliveries, caesarean sections and admissions to intensive care were 3.5, 1.5 and 44 times higher compared to pregnant women without a heart lesion. The case-fatality rate was 2.0%.</p><p><strong>Conclusion: </strong>Women with a cardiac lesion in pregnancy had more interventions, higher morbidity and mortality compared to women without a cardiac lesion. Early diagnosis and evaluation of cardiac function were essential for better maternal outcomes. All pregnant women should be screened with an echocardiogram to improve early detection of cardiac lesions.   </p></div>

scholarly journals Cardiac Drugs in Pregnancy

2018 ◽  
Vol 03 (02/03) ◽  
pp. 155-160
Author(s):  
Donepudi Aruna ◽  
Mekala Padmaja
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Cardiac Disease ◽  
Signs And Symptoms ◽  
Cardiac Lesions ◽  
Changes In Pregnancy ◽  
Pedal Edema ◽  
Physiologic Changes Of Pregnancy ◽  
Rheumatic Heart ◽  
In Pregnancy

AbstractHeart disease complicating pregnancy is an indirect cause of maternal mortality and its incidence in India is 1 to 4%. Cardiac disease in pregnant women is most commonly due to rheumatic heart disease (RHD), congestive heart failure, and less commonly due to ischemic heart disease or cardiomyopathy. Though the frequency of RHD has decreased worldwide, it is still predominant in developing countries such as India. Around 15 to 52% of cardiac abnormalities first diagnosed during routine antenatal checkups or due to the signs and symptoms caused by physiologic changes of pregnancy. The most common clinical features of cardiac lesions such as breathlessness, pedal edema, and murmurs that mimic normal physiologic changes in pregnancy pose a diagnostic difficulty for obstetricians.

scholarly journals 31. Influenza Vaccination During Pregnancy: A Descriptive Cross-sectional Survey of the Knowledge, Beliefs, and Attitudes of Mexican Gynecologists and Family Physicians

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S39-S39
Author(s):  
Erika Z Lopatynsky-Reyes ◽  
Sue Ann Costa-Clemens ◽  
Enrique Chacon-Cruz ◽  
Michael Greenberg
Keyword(s):  
Influenza Vaccination ◽  
Pregnant Women ◽  
Latin American ◽  
Vaccine Coverage ◽  
Family Physicians ◽  
Morbidity And Mortality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Beliefs And Attitudes ◽  
In Pregnancy

Abstract Background Influenza in pregnancy is associated with elevated morbidity and mortality. Influenza vaccines are both safe and effective in pregnancy, supporting routine use in this population. Even though influenza vaccination in Mexico is recommended for pregnant women, there are no publications of influenza vaccine coverage in pregnancy. This is the first Latin American survey done only in physicians aiming to assess the knowledge, beliefs, and attitudes that Mexican Obstetrics-Gynecologists (OBG) and Family Physicians (FP) have towards influenza and influenza immunization during pregnancy. Methods A cross-sectional survey was conducted, both paper-based and online. The questionnaire was composed of 35 questions, which addressed general knowledge of influenza, recommendations for vaccination during pregnancy, and beliefs and attitudes concerning the acceptability of the vaccine in pregnant women. Results A total of 206 completed surveys were available, 98 (47.6%) from OBG, 108 (52.4%) from FP. Regarding current practicing medical institutions, 76 (37%), 69 (34%), 31 (14.5%), 30 (14.5%) reported working for the Mexican Institute of Social Security, Private Sector, Secretariat of Health, or a combination of all respectively, representing an estimated 2,472 daily pregnancy consultations. About a quarter (26.2%) reported not having a notion that influenza is more severe among pregnant women. More than half (51.5%) ignored the potential side effects of influenza infection on the fetus. The majority (56.8%) did not know when vaccination during pregnancy should occur. Pregnancy as a risk factor for developing influenza complications was known only in 48.1%. Also, 46.1 % believed that vaccination only confers protection to the mother, but not to the fetus. Nevertheless, 96.1% considered that immunization against influenza during pregnancy is a safe and effective preventive intervention. A results’ summary is shown in Figure-1. Conclusion Based on this survey, current knowledge of OBG and FP for influenza morbidity and mortality during pregnancy, and the importance of influenza vaccination in pregnant women, is poor. Mandatory recommendations to educate medical providers regarding influenza vaccination during pregnancy in Mexico are necessary, even as imperative for CME credits. Disclosures All Authors: No reported disclosures

scholarly journals Maternal and fetal outcomes in rheumatic heart disease in pregnancy

2014 ◽  
Vol 2 (4) ◽  
pp. 1632
Author(s):  
Dhivya Sethuraman ◽  
Nirmala Ramachandran ◽  
SAP Noorjahan ◽  
Vijay Kanna
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Fetal Outcomes ◽  
Heart Disease In Pregnancy ◽  
Rheumatic Heart ◽  
In Pregnancy

scholarly journals Maternal Outcome in Mitral Valve Disease with Pulmonary Hypertension: Two Case Reports

2018 ◽  
Vol 03 (02/03) ◽  
pp. 204-208
Author(s):  
Anuradha Alagandala ◽  
Daya Vaswani ◽  
Vuduthala Bharadwaj ◽  
Kousalya Chakravarthy
Keyword(s):  
Pulmonary Embolism ◽  
Heart Disease ◽  
Mitral Stenosis ◽  
Maternal Morbidity ◽  
Fatal Case ◽  
Morbidity And Mortality ◽  
First Case ◽  
Asymptomatic Patients ◽  
Maternal Morbidity And Mortality ◽  
In Pregnancy

AbstractChronic rheumatic heart disease is still the leading cause of heart disease complicating pregnancy in the developing countries. The physiologic changes in pregnancy and stress induced by the increase in cardiac output can cause asymptomatic patients with mitral stenosis to decompensate, especially in the third trimester. Severity of mitral stenosis is reflected by the decrease in the valve area and increase in the right ventricular systolic pressures (RVSPs). Venous thromboembolism (VTE) is two to five times more common in the postpartum period, and the risk is high with cesarean delivery. Pulmonary embolism in pregnancy can cause severe maternal morbidity and mortality. We describe two cases of severe mitral stenosis complicating pregnancy with grossly elevated RVSP. The first case is the successful management of a second gravida, presenting with severe mitral stenosis with RVSP 80 mm Hg, and the second, a fatal case of a 26-year-old para 1, live 1, delivered by cesarean section, presenting with massive fatal pulmonary embolism on 13th postoperative day (POD) with RVSP 90 mm Hg. A multidisciplinary approach involving the cardiologist, obstetrician, and obstetric anesthesiologist is crucial for management of severe mitral stenosis complicating pregnancy, to decrease the maternal morbidity and mortality during peripartum period.

Rheumatic heart disease in pregnancy: Profile of women admitted to a Western Australian tertiary obstetric hospital

2020 ◽  
Vol 60 (2) ◽  
pp. 302-308
Author(s):  
Chris O. Ongzalima ◽  
Melanie Greenland ◽  
Geraldine Vaughan ◽  
Andre Ng ◽  
Jordan A. Fitz‐Gerald ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Heart Disease In Pregnancy ◽  
Western Australian ◽  
Rheumatic Heart ◽  
In Pregnancy

scholarly journals Brain natriuretic peptide in pregnant women with heart disease

2019 ◽  
Vol 13 (1) ◽  
pp. 25-29
Author(s):  
Karanvir Singh ◽  
Pooja Sikka ◽  
Vanita Suri ◽  
Rishikesh Prasad ◽  
Madhu Khullar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Adverse Event ◽  
Heart Disease ◽  
Adverse Events ◽  
Brain Natriuretic Peptide ◽  
Pregnant Women ◽  
Natriuretic Peptide ◽  
Cardiac Events ◽  
Plasma Brain Natriuretic Peptide ◽  
Rheumatic Heart

Background Plasma brain natriuretic peptide levels were prospectively studied in pregnant women with heart disease. Methods Fifty pregnant women with heart disease and 25 controls were evaluated at 24 weeks or under, 30–32 weeks, 34 weeks or more of gestation, and 6 weeks postpartum. Adverse maternal cardiac events were hospitalization for worsening heart failure, stroke, and death. Results Thirty-eight (76%) women had rheumatic heart disease. Plasma brain natriuretic peptide levels were (in cases and controls) 118.3 ± 46.5 pg/ml and 66.3 ± 15.9 pg/ml (at 24 weeks or under), 124.8 ± 30.4 pg/ml and 68.4 ± 16.5 pg/ml (30–32 weeks), 135.8 ± 34.9 pg/ml and 68.6 ± 15.6 pg/ml (34 weeks or more), and 110.1 ± 21.9 pg/ml and 65.0 ± 16.1 pg/ml (6 weeks postpartum) (p = .0001). Eighteen women had adverse events. Of these, only 1 had a level less than 100 pg/ml, 12 were between 100 and 200 pg/ml, and 5 more than 200 pg/ml. Conclusions Plasma brain natriuretic peptide levels were higher in women with heart disease at all periods of gestation as well as six weeks postpartum. No woman with a plasma brain natriuretic peptide levels of 98 pg/ml or less had an adverse event.

Echocardiographic screening of pregnant women by non-physicians with remote interpretation in primary care

2020 ◽  
Author(s):  
Bruno R Nascimento ◽  
Craig Sable ◽  
Maria Carmo P Nunes ◽  
Kaciane K B Oliveira ◽  
Juliane Franco ◽  
...  
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Pregnant Women ◽  
Rheumatic Heart Disease ◽  
Morphological Changes ◽  
Severe Disease ◽  
Left Ventricular ◽  
Rheumatic Heart

Abstract Background Impact of heart disease (HD) on pregnancy is significant. Objective We aimed to evaluate the feasibility of integrating screening echocardiography (echo) into the Brazilian prenatal primary care to assess HD prevalence. Methods Over 13 months, 20 healthcare workers acquired simplified echo protocols, utilizing hand-held machines (GE-VSCAN), in 22 primary care centres. Consecutive pregnant women unaware of HD underwent focused echo, remotely interpreted in USA and Brazil. Major HD was defined as structural valve abnormalities, more than mild valve dysfunction, ventricular systolic dysfunction/hypertrophy, or other major abnormalities. Screen-positive women were referred for standard echo. Results At total, 1 112 women underwent screening. Mean age was 27 ± 8 years, mean gestational age 22 ± 9 weeks. Major HD was found in 100 (9.0%) patients. More than mild mitral regurgitation was observed in 47 (4.2%), tricuspid regurgitation in 11 (1.0%), mild left ventricular dysfunction in 4 (0.4%), left ventricular hypertrophy in 2 (0.2%) and suspected rheumatic heart disease in 36 (3.2%): all, with mitral valve and two with aortic valve (AV) involvement. Other AV disease was observed in 11 (10%). In 56 screen-positive women undergoing standard echo, major HD was confirmed in 45 (80.4%): RHD findings in 12 patients (all with mitral valve and two with AV disease), mitral regurgitation in 40 (14 with morphological changes, 10 suggestive of rheumatic heart disease), other AV disease in two (mild/moderate regurgitation). Conclusions Integration of echo screening into primary prenatal care is feasible in Brazil. However, the low prevalence of severe disease urges further investigations about the effectiveness of the strategy.

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