scholarly journals Fetomaternal Outcome in Pregnancy With Cardiac Disease

2012 ◽  
Vol 23 (1) ◽  
pp. 31-35
Author(s):  
Shahanaj Sharmin ◽  
Shahanara Chowdhury ◽  
Didarul Alam ◽  
Mohiuddin Ahmed ◽  
Fahamida Rashid ◽  
...  
Keyword(s):  
Heart Disease ◽  
Birth Weight ◽  
Pregnant Women ◽  
Rheumatic Heart Disease ◽  
Cardiac Disease ◽  
Cross Sectional Study ◽  
Normal Vaginal Delivery ◽  
College Hospital ◽  
Cross Sectional ◽  
Rheumatic Heart

Aim of our study was to see the maternal and fetal outcomes in women presenting with heart disease during pregnancy and labout. This cross sectional study was carried out in 48 pregnant women with cardiac disease from July 2005 to Dec 2006, in the department of Gynae and Obst at Chittagong Medical College Hospital Chittagong. The Mewan age was 25.40 ±4.46 years. 31(64.6%) patients were from middle class. 27 (56.3%) patients belonged to mulliparous group. 33(68.8%) patients received regular antenatal care, of the 43 (89.7%) patients had rheumatic heart disease and 5(10.5%) had congenital heart disease. Among the rheumatic heart disease, 50% had mitral stenosis. 35(72.9%) patients had in grade-1, 12(25%) had in grade-II, and 1(2.1%) had in grade-III. (64.5%) had normal vaginal delivery, 7(14.5%) had LSCS. 4(8.3%) had heard failure and 1 patient (2.1%) expired due to heart failure, 40(83.3%) were delivered at term, 7(14.6%) had preterm labour and 1(2.1%) had still birth. Regarding birth weight, 17(35.4%) had LBW (Low birth weight), 31(64.6%) had normal birth weight. Rheumatic heart disease is the commonest cardiac lesion among Pregnant women. Fetomaternal morbidity and mortality are strongly correlated with maternal cardiac functional classification. The management of these cases should be multidisciplinary to optimize care of these patients. JCMCTA 2012; 23(1): 31-35

scholarly journals Rheumatic Heart Disease among Pregnant Women with Cardiac Diseases in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Basant Sharma ◽  
Eliza Koirala ◽  
Sudhir Regmi ◽  
Jaya Dhungana ◽  
Bandana Khanal Neupane ◽  
...  
Keyword(s):  
Heart Disease ◽  
Confidence Interval ◽  
Pregnant Women ◽  
Rheumatic Heart Disease ◽  
Cardiac Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Rheumatic Heart

Introduction: Cardiac disease in pregnancy is a major cause of maternal mortality and morbidity in women, particularly in resource limited countries like Nepal. Rheumatic Heart Disease is the commonest cardiac disease complicating pregnancy. There is very limited data and evidence from Nepal regarding rheumatic heart disease complicating the pregnancy. The study aims to find out the prevalence of rheumatic heart disease among cardiac disease patients in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among 41 women with cardiac disease who delivered babies at Chitwan Medical College from 1st January 2018 to 31st December 2019, after taking ethical approval from the Institutional Review Committee. A convenient sampling method was used. Statistical Package for the Social Sciences was used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 41 pregnant women with cardiac disease, 32 (78%) (95% Confidence Interval = 65.32-90.68) had rheumatic heart disease. The mean age of the affected pregnant women was 24.9±4.49 years. Out of 32 patients with rheumatic heart disease, postpartum haemorrhage was the most common maternal complication 5 (15.6%) followed by hypertension 4 (9.7%). Conclusions: Rheumatic Heart Disease was highly common among pregnant women with cardiac disease.

Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal

2020 ◽  
Vol 01 (01) ◽  
pp. 009-012
Author(s):  
Laudari S
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Rheumatic Heart

Background and Aims: Secondary prophylaxis has remained the mainstay of rheumatic fever and rheumatic heart disease management. Despite the proven ef􀏐icacy and superiority of injectable penicillin in rheumatic heart disease patients, it has been underused in Nepal. Materials and Methods: This is a hospital based cross-sectional study during June 2014 to October 2018 over a period of 52 months at College of Medical Sciences-Bharatpur including 350 patients with clinical and/or echocardiographic evidence of de􀏐inite rheumatic heart disease. Data was collected from both cardiology outpatients and inpatients (admitted in cardioward/coronary care unit). Relevant data and information were entered into the pre-structured proforma and then analyzed by SPSS-16 software. Results: The age of the patients ranged from 6 to 80 years with mean age 36.76±4.6years with female preponderance (F:M=1.26:1). The predominantly involved isolated valve was mitral in 152 patients (44.43%) followed by aortic valve in 70 patients (20.00%) and rest 90 (25.71%) had dual valvular involvement. The common complications encountered were heart failure in 200(57.14%) and arrhythmias in 155(44.29%) patients. Two hundred ten (60.00%) of the patients received penicillin (oral and injectable) and erythromycin. Majority 180/210=85.71%) were prescribed on oral penicillin whereas only 46/210=21.90% received injectable penicillin; the ratio being 3.35:1. Conclusion: RHD is a leading cause of heart failure and death among young population. There is underuse of penicillin with very minimal focus on use of injectable penicillins currently. Hence, Nepal government and other non-governmental organizations should consider implementation of use of penicillin broadly and moreover focus on use and adherence of injectable penicillin. Keywords: Rheumatic Heart Disease, Penicillin, Underuse, Secondary Prophylaxis.

scholarly journals Maternal outcomes of rheumatic heart disease in pregnancy

2017 ◽  
Vol 6 (3) ◽  
pp. 802
Author(s):  
Hema Priya L. ◽  
Ambarish Bhandiwad ◽  
Nagaraj Desai ◽  
Triveni Kondareddy
Keyword(s):  
Heart Disease ◽  
Birth Weight ◽  
Functional Status ◽  
Rheumatic Heart Disease ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Heart Disease In Pregnancy ◽  
Rheumatic Heart ◽  
In Pregnancy

Background: Preexisting cardiac disease is seen in 1-3% of pregnancies. In developing countries, sequelae of rheumatic fever often constitute the majority of women with heart disease; whereas in developed countries, it is the congenital heart diseases. The aim of this study was to examine the changing trends and mode of care of women with Rheumatic heart disease in pregnancy over a period of five years in a tertiary care centre.Methods: Patient records over five years were retrieved and maternal and perinatal outcomes were documented. The present study reports the outcomes of 72 women with rheumatic heart disease.Results: The prevalence of heart disease in pregnancy in our study was 1.72%. The prevalence was higher among the rural population, and in lower socio economic strata. 30% of patients were diagnosed during pregnancy. The risk of complications co - related with their functional status at the onset of pregnancy. The mode of termination of pregnancy and indications for LSCS did not vary. However, the risk of complications was greatest during labour and post-partum period. The mean birth weight was 2.7 kg, however, 30% of term neonates were of low birth weight (<2.5 kg).Conclusions: Rheumatic heart disease continues to be a major cause of cardiac disease complicating pregnancy. However, early diagnosis, appropriate management prior to pregnancy, and good functional status at the time of entering pregnancy allowed for a good maternal and neonatal outcome.

scholarly journals Maternal Weight Gain and its Relationship with Birth Weight of Baby at Term

2020 ◽  
Vol 32 (2) ◽  
pp. 79-83
Author(s):  
Shiffin Rijvi ◽  
Sharmin Abbasi ◽  
Farhana Dewan ◽  
Sehereen Farhad Siddiqua ◽  
Anuradha Karmakar
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Large For Gestational Age ◽  
Maternal Weight Gain ◽  
Maternal Weight ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Background: Perinatal health is influenced by maternal weight gain. Increase in obesity in population and excess weight during pregnancy may be different complications including large for gestational age fetus. As a result cesarean delivery has increased in prevalence. Maternal weight gain during the 2nd and 3rd trimesters is an important determinant of fetal growth Objective: To determine the relationship between maternal weight gain and birth weight of baby at term. Methodology : A cross sectional study was carried among 50 pregnant women at term in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College and Hospital and Anwer Khan Modern Medical College Hospital during the period of January 2013 to July 2013. Data were collected in pre-designed data collection sheet. Results: This study found maximum (36%) were age group 21-25 years followed by 28% were ≤20 years, 24% were between 26-30 years, 8% were between 31-35 years and only 4% were of 36-40 years. The average age was 25 years. Among these 50 pregnant women, 2 cases (4%) had BMI < 18.5, 15 cases (30%) had a BMI 18.5-24.9, 19 cases (38%) had a BMI 25-29.9 and 14 cases (28%) had a BMI ≥30. The mean birth weight was 2.77±0.33. kg. Mean weight gain was 10.72±3.72 Kg. Conclusion: This study showed that reasonable maternal weight gain significantly increased birth weight of the baby at term. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 79-83

scholarly journals Throat colonization and antibiotic susceptibility of group A β-hemolytic streptococci among rheumatic heart disease patients attending a cardiac referral hospital in Tanzania, A descriptive cross-sectional study

2019 ◽  
Author(s):  
Sarah Wangilisasi ◽  
Pilly Chillo ◽  
Delila Kimambo ◽  
Mohammed Janabi ◽  
Appolinary Kamuhabwa
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Antibiotic Susceptibility ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Group A ◽  
Rheumatic Heart

Abstract Background: Secondary prophylaxis against repeated attacks of acute rheumatic fever is an important intervention in patients with rheumatic heart disease (RHD) and it aims to prevent throat infection by group A beta-hemolytic streptococcus (GAS), however its implementation faces many challenges. This study aimed to assess throat colonization, antibiotic susceptibility and factors associated with GAS colonization among patients with RHD attending care at Jakaya Kikwete Cardiac Institute in Dar-es-Salaam, Tanzania. Methods: A descriptive cross sectional study of RHD patients attending the Jakaya Kikwete Cardiac Institute was conducted from March to May 2018, where we consecutively enrolled all patients known to have RHD and coming for their regular clinic follow-up. A structured questionnaire was used to obtain patients’ socio-demographic information, factors associated with GAS colonization as well as status of secondary prophylaxis use and adherence. Throat swabs were taken and cultured to determine the presence of GAS, and isolates of GAS were tested for antibiotic susceptibility using Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) version 2015. Antibiotics of interest were chosen according to the Tanzanian Treatment Guidelines. Results: In total 194 patients with RHD were enrolled, their mean age was 28.4 ±16.5 years and 58.2% were females. Only 58 (29.9%) patients were on regular prophylaxis, 39 (20.1%) had stopped taking prophylaxis, while 97 (50.0%) had never been on prophylaxis. Throat cultures were positive for GAS in 25 (12.9%) patients. Patients who stopped prophylaxis were 3.26 times more likely to be colonized by GAS when compared to patients on regular prophylaxis. Majority (96%) of GAS isolates were susceptible to Penicillin, Ceftriaxone and Ciprofloxacin, while the highest resistance (20%) was observed with Vancomycin. No GAS resistance was observed against Penicillin. Conclusion: The prevalence of GAS throat colonization is high among this population and is associated with stopping prophylaxis. The proportion of patients on regular secondary prophylaxis is unacceptably low and interventions should target both patients’ and physicians’ barriers to effective secondary prophylaxis.

scholarly journals Karakteristik Pasien Penyakit Jantung Rematik yang Dirawat Inap di RSUP Dr. M. Djamil Padang

2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Marhamah Hasnul ◽  
Najirman Najirman ◽  
Yanwirasti Yanwirasti
Keyword(s):  
Heart Disease ◽  
Elementary Education ◽  
Rheumatic Heart Disease ◽  
Heart Valve ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chest X Ray ◽  
Rheumatic Heart

Abstrak Penyakit jantung rematik (PJR) adalah penyakit jantung sebagai akibat adanya gejala sisa (sekuele) dari demam rematik (DR) yang ditandai dengan terjadinya cacat katup jantung. Tujuan penelitian ini adalah melihat karakteristik pasien penyakit jantung rematik.yang dirawat. Metode yang digunakan adalah deskriptif observasional dengan desain cross sectional study dan pendekatan retrospektif untuk menilai karakteristik pasien PJR di RSUP Dr. M. Djamil Padang dari Januari 2009 - Desember 2012. Populasi dan sampel sebanyak 54 sampel. Hasil penelitian menunjukkan distribusi pasien terbanyak pada kelompok umur 11-20 tahun (50%), perempuan (57,41%), tingkat pendidikan SD/sederajat dan SLTP/sederajat masing-masing 25,93%, pelajar/mahasiswa (53,70%), dan berasal dari daerah rural (70,37%). Sebagian besar pasien mengeluhkan keluhan utama sesak napas (62,96%). Hasil pemeriksaan elektrokardiografi memperlihatkan LVH sebesar 35,19% dan AF sebesar 27,78%. Berdasarkan pemeriksaan foto toraks umumnya pasien telah mengalami kardiomegali (92,59%). Berdasarkan pemeriksaan ekokardiografi yang paling banyak ditemukan adalah kelainan katup regurgitasi mitral (30,40%), derajat kerusakankatup berat (36,80%), dan fraksi ejeksi normal (72,97%). Pada penelitian ini dapat disimpulkan bahwa terdapat variasi karakteristik dari penderita PJR yang ada di RSUP Dr. M. Djamil Padang. Kata kunci: penyakit jantung rematik, karakteristikAbstract Rheumatic heart disease is a cardiovascular disease caused by delayed sequele of rheumatic fever characterized by heart valve damage. The objective of this study was to observe the characteristics of RHD patients.This study is a descriptive observasional with cross-sectional study design and the retrospective by observing the characteristics of RHD patients in RSUP Dr. M. Djamil Padang from Januari 2009 – December 2012. The population and sample of this study was 54 patients. The result of this study showed that majority of the patients at the age group 11-20 years (50%), female (57.41%), elementary education degree/equal and junior high/equal of each 25.93%, students/university students (53.70%), and come from rural areas (70.37%). Most patients complained experiencedbreathlessness (62.96%). The result of electrocardiography showed LVH is the the highest (35.19%) and AF 27.78%. Based on chest X-ray examination majority of the patients showed a cardiomegaly (92.59%). Based on echocardiography examination, the most heart valve damage is mitral regurgitation (30.40%), the severity is severe (36.80%), and the fraction ejection is in normal limit (72.97%). The conclusion of this research, there are variation in the characteristics of RHD patients in RSUP Dr. M. Djamil Padang.Keywords: rheumatic heart disease, characteristics

scholarly journals Patterns of Rheumatic Heart Disease and Treatment Practices at Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Rajesh Nepal ◽  
Madhab Bista ◽  
Sahadeb Prasad Dhungana
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional ◽  
Treatment Practices ◽  
Rheumatic Heart

Introduction: Rheumatic heart disease is a sequel of rheumatic fever which causes heart valve damage. This study was conducted to look at the pattern of valve lesions and treatment practices in patients with rheumatic heart disease. Methods: A cross-sectional study conducted at the tertiary care center with a diagnosis of rheumatic heart disease from July 2018 to January 2020 by convenient sampling. Ethical clearance was obtained from the Institutional Review Committee (ref no. 55/2018). Data were analyzed by using Statistical package for social sciences version 20. Results: Out of 600 patients, 428 (71.3%) were female. The mean age was 44.24±14.24 years. The isolated mitral valve was affected in 280 (46.6%). Dual involvement of mitral and aortic valve was present in 294 (49%). Only 14 (2.3%) had involvement of isolated aortic valve involvement. Overall, mitral stenosis was the most common abnormality 508 (84.6%) followed by mitral regurgitation 418 (69.6%), aortic regurgitation 320 (53.3%), and aortic stenosis 63 (10.5%). Assessment of the severity of lesions showed that 247 (41.2%) patients had severe mitral stenosis, 119 (19.8%) severe mitral regurgitation, 14 (2.3%) severe aortic stenosis, and 11 (1.8%) severe aortic regurgitation. Majority 493 (82.2%) were treated with medical therapies. Surgical procedures were performed in 51 (8.5%). The use of anticoagulation was in 212 (35.3%) of eligible patients. Conclusions: Mitral valve was affected commonly both in isolation and combination. The majority of patients who were eligible for cardiac interventions were treated medically with suboptimal use of anticoagulation and secondary prophylaxis.

Telehealth solutions to enable global collaboration in rheumatic heart disease screening

2016 ◽  
Vol 24 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Eduardo LV Lopes ◽  
Andrea Z Beaton ◽  
Bruno R Nascimento ◽  
Alison Tompsett ◽  
Julia PA dos Santos ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Low Cost ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Disease Screening ◽  
Minas Gerais ◽  
Initial Image ◽  
Cross Sectional ◽  
Rheumatic Heart

Background The global burden of rheumatic heart disease is nearly 33 million people. Telemedicine, using cloud-server technology, provides an ideal solution for sharing images performed by non-physicians with cardiologists who are experts in rheumatic heart disease. Objective We describe our experience in using telemedicine to support a large rheumatic heart disease outreach screening programme in the Brazilian state of Minas Gerais. Methods The Programa de Rastreamento da Valvopatia Reumática (PROVAR) is a prospective cross-sectional study aimed at gathering epidemiological data on the burden of rheumatic heart disease in Minas Gerais and testing of a non-expert, telemedicine-supported model of outreach rheumatic heart disease screening. The primary goal is to enable expert support of remote rheumatic heart disease outreach through cloud-based sharing of echocardiographic images between Minas Gerais and Washington. Secondary goals include (a) developing and sharing online training modules for non-physicians in echocardiography performance and interpretation and (b) utilising a secure web-based system to share clinical and research data. Results PROVAR included 4615 studies that were performed by non-experts at 21 schools and shared via cloud-telemedicine technology. Latent rheumatic heart disease was found in 251 subjects (4.2% of subjects: 3.7% borderline and 0.5% definite disease). Of the studies, 50% were preformed on full functional echocardiography machines and transmitted via Digital Imaging and Communications in Medicine (DICOM) and 50% were performed on handheld echocardiography machines and transferred via a secure Dropbox connection. The average time between study performance date and interpretation was 10 days. There was 100% success in initial image transfer. Less than 1% of studies performed by non-experts could not be interpreted. Discussion A sustainable, low-cost telehealth model, using task-shifting with non-medical personal in low and middle income countries can improve access to echocardiography for rheumatic heart disease.

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