scholarly journals Cardiovascular diseases during pregnancy and delivery

2013 ◽  
Vol 66 (11-12) ◽  
pp. 507-513
Author(s):  
Zoran Stajic ◽  
Zdravko Mijailovic ◽  
Mirjana Bogavac ◽  
Biljana Lazovic ◽  
Maja Stojanovic
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Cardiovascular System ◽  
Maternal Morbidity ◽  
Morbidity And Mortality ◽  
Circulating Blood Volume ◽  
Maternal Morbidity And Mortality ◽  
In Pregnancy

Introduction. Nowadays, cardiovascular diseases are the leading cause of maternal morbidity and mortality in the current obstetric practice. Physiologically Adapted Mechanisms of the Cardiovascular System in Pregnancy. It is normal that during pregnancy some physiological adaptive changes of the cardiovascular system occur and they may contribute to the deterioration of the clinical cardiac status of a patient with preexisting or acquired cardiovascular disease. The most prominent adaptive mechanisms include the increase of circulating blood volume, decrease of peripheral vascular resistance and decrease of plasma colloid-oncotic pressure. Most Frequent Diseases of the Cardiovascular System in Pregnancy. Due to these changes, pregnant women are prone to tachycardia, palpitations and peripheral edema. Maternal counseling is obligatory for each pregnant woman in order to decrease the maternal morbidity and mortality. The most important predictors of maternal mortality for pregnant women with cardiovascular diseases are severity of pulmonary hypertension, hemodynamic significance of valvular lesion, cyanosis and functional status in heart failure. Cardiovascular diseases in pregnant women may be congenital or acquired. The most frequent congenital cardiac diseases are atrial and ventricular septal defects as well as persistent ductus arteriosus. These diseases are mainly diagnosed and corrected before the pregnancy, or left untreated if hemodynamically insignificant. The most frequent acquired cardiovascular diseases during pregnancy include arrhythmias, ischemic heart disease, rheumatic mitral stenosis and insufficiency, arterial hypertension and aortic dissection. Conclusion. In all cases of pregnancy associated with cardiovascular diseases, early recognition of cardiovascular disease is crucial, as well as correct diagnosis and referral to a tertiary centre equipped for a multidisciplinary approach of specialists experienced in high-risk pregnancies and deliveries in order to prevent maternal mortality.

scholarly journals Venomous Snakebite in Pregnancy and Good Outcome –A Case Report

2016 ◽  
Vol 27 (2) ◽  
pp. 86-88
Author(s):  
Mohammad Ali ◽  
Md Robed Amin ◽  
Mohammad Belalul Islam ◽  
Mohammad Haresur Rahman ◽  
Md Mahbubul Islam Mojumdar
Keyword(s):  
Case Report ◽  
Maternal Morbidity ◽  
Medical Literature ◽  
Morbidity And Mortality ◽  
Good Outcome ◽  
Fetal Wastage ◽  
Maternal Morbidity And Mortality ◽  
In Pregnancy

Worldwide occurrence of snakebite in pregnancy is little known in medical literature. Furthermore to the best of our knowledge there is no case report on Krait envenomation in pregnancy in Bangladesh. It carries significant fetal wastage and maternal morbidity and mortality. Here we report a mutligravida aged 27 years at her 24 weeks of gestation with krait bite with neuroparesis with good obstetrical outcome.Bangladesh J Medicine Jul 2016; 27(2) : 86-88

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.

scholarly journals Obstetric Hemorrhage, its role in maternal morbidity and mortality and the importance of its diagnosis, prevention and timely management

2020 ◽  
Vol 8 (15) ◽  
pp. 37-44
Author(s):  
Ixchel Suyapa Reyes Espinoza
Keyword(s):  
Maternal Mortality ◽  
Latin American ◽  
Maternal Morbidity ◽  
Morbidity And Mortality ◽  
World Health ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Anesthetic Care ◽  
Obstetric Haemorrhage ◽  
Maternal Morbidity And Mortality

Background: In recent years, different international and national campaigns have been implemented to combat obstetric haemorrhage. Maternal mortality (MM) is one of the main concerns of public health and represents a good indicator to measure the quality of care, an indicator that also allows to establish the socioeconomic differences between countries. There are still many activities to be carried out and achieve the objective set by the World Health Organization (WHO) and the Latin American Federation of Societies in Obstetrics and Gynaecology (FLASOG) "Zero deaths due to haemorrhage". Objective: Based on the scientific evidence available, deepen the knowledge of the role of obstetric haemorrhage as the main avoidable cause of maternal morbidity and mortality. Methodology: retrospective study through the search of original articles and systematic reviews in: Elsevier, Lancet, Intramed, PubMed, EMBASE, ScienceDirect and Cochrane Library. The following keywords were used for all sites: "Obstetric haemorrhage", "Maternal mortality and obstetric haemorrhage", "Maternal morbidity and obstetric haemorrhage", "Postpartum, late, secondary haemorrhage". The items with the highest level of evidence were selected. Conclusions: Obstetric haemorrhage is still a potential cause of maternal and fetal morbidity and mortality. Its appearance at any time of pregnancy is a cause for concern and alarm. Despite advances in obstetric and anesthetic care, its treatment remains a challenge for the surgical team, anesthesiologist, gynaecologist and Pediatrician.

scholarly journals The screening of heart disease by cardiac auscultation and electrocardiography examination in pregnant women in Puskesmas Tegalrejo, Yogyakarta, Indonesia

2021 ◽  
Vol 4 (3) ◽  
pp. 155
Author(s):  
Lucia Kris Dinarti ◽  
Detty Siti Nurdiati ◽  
Anggoro Budi Hartopo ◽  
Fika Humaeda Assilmi ◽  
Alifia Salsabila ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Maternal Morbidity ◽  
Screening Program ◽  
Screening Method ◽  
Morbidity And Mortality ◽  
Cardiac Auscultation ◽  
Heart Murmurs ◽  
Maternal Morbidity And Mortality ◽  
Secondary Screening

Women adapt to pregnancy through multi-organ system physiologic changes, including cardiovascular adaptations. These changes affect those with pre-existing cardiovascular problems differently, and subsequently lead to higher probability of death caused by cardiovascular diseases during pregnancy. Therefore, detection of cardiovascular disease early in pregnancy is important to lower maternal morbidity and mortality by providing prompt and adequate management. This study aimed to evaluate and test the feasibility of integrating 12-lead electrocardiogram (ECG) examination and antenatal care (ANC) screening as a simple and effective method for early detection of heart abnormality in pregnant woman. Pregnant women were recruited in this study in any trimester who attended ANC for a routine pregnancy examination in Puskesmas Tegalrejo Yogyakarta. The subjects underwent primary screening which focused on cardiac auscultation and 12-lead ECG examinations, and those who had abnormal findings were further followed-up in secondary screening by using trans-thoracic echocardiography to confirm heart abnormality. A total of 523 pregnant women from Puskesmas Tegalrejo were included in this study. 15 (2.8%) pregnant woman were suspected to have heart abnormalities; from those, 3 (0.5%) were found with heart murmurs with abnormal ECG readings, 1 (0.19%) had heart murmurs with normal ECG results, and 11 (2.1%) had abnormal ECG readings only. The secondary screening of those patients resulted in 1 (0.19%) pregnant woman who was diagnosed with Atrial Septal Defect. Our study found that among 15 patients identified with suspected ECG abnormalities, one mother who underwent ANC was newly diagnosed with a pre-existing cardiac abnormality. Our study concluded this screening method is a simple and feasible integrated heart screening program that can be implemented widely. We hope this integrated heart screening program may benefit pregnant women who may have cardiac abnormalities to be detected as early as possible, thus reducing maternal morbidity and mortality.

scholarly journals Pulmonary complications for women with sickle cell disease in pregnancy: systematic review and meta-analysis

Thorax ◽  
2020 ◽  
Vol 75 (7) ◽  
pp. 568-575 ◽  
Author(s):  
Sivarajini Inparaj ◽  
Mickey Buckingham ◽  
Laura Oakley ◽  
Paul T Seed ◽  
Sebastian Lucas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Maternal Morbidity ◽  
Meta Analysis ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
Cell Disease ◽  
Maternal Morbidity And Mortality ◽  
In Pregnancy

BackgroundSickle cell disease (SCD) is a multisystem disease characterised by vaso-occlusive crisis, chronic anaemia and a shorter lifespan. More patients with SCD are living till reproductive age and contemplating pregnancy. Pulmonary complications in pregnancy are significant causes of maternal morbidity and mortality but yet this has not been systematically quantified. A systematic review and meta-analysis were conducted to quantify the association between SCD and pulmonary complications in pregnancy.MethodsMEDLINE, EMBASE, Web of Science, Cochrane and Maternity and Infant Care databases were searched for publications between January 1998 and April 2019. Observational studies involving at least 30 participants were included. Random-effects models were used for statistical meta-analysis.FindingsTwenty-two studies were included in the systematic review and 18 in the quantitative analysis. The meta-analysis included 3964 pregnancies with SCD and 336 559 controls. Compared with women without SCD, pregnancies complicated by SCD were at increased risk of pulmonary thromboembolism (relative risk (RR) 7.74; 95% CI 4.65 to 12.89). The estimated prevalence of acute chest syndrome and pneumonia was 6.46% (95% CI 4.66% to 8.25%), with no significant difference between the HbSS and HbSC genotypes (RR 1.42; 95% CI 0.90 to 2.23).InterpretationThis meta-analysis highlighted a strong association between SCD and maternal pulmonary complications. Understanding the risks of and the factors associated with pulmonary complications would aid preconceptual counselling and optimal management of the condition in pregnancy, thereby reducing associated maternal morbidity and mortality.PROSPERO registration numberCRD42019124708.

scholarly journals Nutrition and maternal morbidity and mortality

2001 ◽  
Vol 85 (S2) ◽  
pp. S93-S99 ◽  
Author(s):  
Andrew Tomkins
Keyword(s):  
Vitamin A ◽  
Maternal Mortality ◽  
Maternal Morbidity ◽  
Maternal Diet ◽  
Beta Carotene ◽  
Subclinical Mastitis ◽  
Major Effect ◽  
Morbidity And Mortality ◽  
Nutritional Interventions ◽  
Maternal Morbidity And Mortality

Nearly 600 000 women die every year from pregnancy related conditions and the maternal mortality rates (MMR = deaths per 100 000 live births) in developing countries may be as high as 1000 compared with less than ten in industrialised countries. In the light of the striking impact of deficiencies of micronutrients such as vitamin A and zinc on immune function, morbidity and mortality in children it seems reasonable to suggest that such deficiencies might play a contributing role in the high rates of morbidity and mortality in mothers. Hitherto, there has been rather little published on the contribution of malnutrition to maternal morbidity or mortality but recent results of micronutrient supplementation show a major effect of vitamin A or beta carotene supplementation on maternal mortality in Nepal and an impressive effect of a multiple micronutrient mixture on pregnancy outcome in Tanzania. There is now data showing that subclinical mastitis, a potential risk factor for mother to child transmission of HIV by increasing levels of virus in breast milk, is influenced by maternal diet in Tanzania and feeding patterns in South Africa. Considering the massive tragedy of maternal mortality the recent data provides opportunities for new, innovative nutritional interventions for the reduction of the global burden of maternal morbidity and mortality.

scholarly journals A rare case of severe pulmonary hypertension in pregnancy

2020 ◽  
Vol 9 (11) ◽  
pp. 4707
Author(s):  
Ramna Banerjee ◽  
Farheen Rahman
Keyword(s):  
Pulmonary Hypertension ◽  
Maternal Morbidity ◽  
Rare Case ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Severe Pulmonary Hypertension ◽  
Maternal Morbidity And Mortality ◽  
In Pregnancy

Heart diseases in pregnancy have always been a source of major concern for both the patients as well as the caregivers because of the high risk of maternal morbidity and mortality and the need for specialist care by a multidisciplinary team preferably in a tertiary care hospital. Amongst the whole gamut of heart diseases, pulmonary hypertension is associated with high maternal morbidity and mortality (in the order of 20% in some studies) and hence is considered a contraindication for pregnancy. We report a rare case of a lady at 36 weeks gestation in her second pregnancy, with a previous caesarean section, who was incidentally diagnosed with severe pulmonary hypertension (PAP-110 mmHg) during her antenatal check-up in the third trimester of pregnancy and survived without any major complications after being promptly referred to and treated in a multispecialty hospital. Her previous pregnancy was absolutely uneventful and even in this pregnancy she had very mild symptoms as compared to the severity of the disease found on further investigation.

scholarly journals An Insight to Burn Related Maternal Morbidity and Mortality in Pregnancy

2015 ◽  
Vol 10 (1) ◽  
pp. 39-42
Author(s):  
H Rijal ◽  
A Rana ◽  
G Chalise
Keyword(s):  
Pregnant Women ◽  
Healthcare Providers ◽  
Morbidity And Mortality ◽  
University Teaching ◽  
Common Source ◽  
Pregnancy And Postpartum ◽  
Maternal Morbidity And Mortality ◽  
Gestational Week ◽  
Flame Burn ◽  
In Pregnancy

Aims: The aim of this study is to study morbidity and mortality of burn cases during pregnancy and postpartum period. Methods: This is a retrospective study conducted at Tribhuvan University Teaching Hospital from April 1998 to July 2014. The data were retrieved from the records in burn ward, intensive care unit and emergency unit. Pregnant women with burn were studied for the nature, degree and the percentage of burn in relation to pregnancy outcome and mortality. Results: There were 32 cases of burn patients with pregnancy. The most common source of burn was kerosene-induced flame (23) followed by domestic firewood (7), boiling water (1) and lightening (1).There were 25 cases of accidental burn and seven were suicidal burn. The age of the patients was ?19 years in 7, 20-24 in 13, 25-29 in 6 and 30-34 in 6 patients. Except for two cases of postpartum burn , all the others occurred during pregnancy between 6-40 gestational week{<12weeks =5, 13-27 weeks =10, 28-36 weeks=4, 37-42 weeks =6 and unknown =7}. There was only one cesarean and three vaginal births and most resulting in stillbirth owing to higher percentage of burn above second degrees. The percentage of burn was <30% in 13, 30- 39% in 3, 40-59 % in 6, 60-69% in 5 and 70-90% in 2 patients. There were nine mortality (28.1%) in women above 30% burn. Conclusions: The most common cause of burn in pregnancy was flame burn. Pregnant women need to be cautioned against flame burn and avoid using kerosene cooking stove to prevent themselves from burn, genuinely necessary steps to be propagated by all healthcare providers and also at the same time counseling against suicide to be done.  

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