Persistent maternal tachycardia: A clinical alert for healthcare professionals providing maternity care in South Africa

N F Moran; O P Khaliq; N C Ngene; J Moodley

In Practice

Persistent maternal tachycardia: A clinical alert for healthcare professionals providing maternity care in South Africa

N F Moran, O P Khaliq, N C Ngene, J Moodley

Abstract

Cardiac disease is one of the commonest causes of indirect maternal deaths globally. This brief report is a reminder that isolated maternal tachycardia at rest is a clinical alert and warrants a detailed history in relation to cardiac disorders, thorough clinical examination of all organ systems, relevant investigations such as imaging, and expert advice to avoid serious adverse events. We reflect on a belatedly investigated persistent maternal tachycardia resulting in a fatal postpartum collapse due to mitral stenosis. The lost window of opportunity for appropriate investigation and management of the tachycardia provides an insight into many similar maternal deaths in South Africa. Key clinical messages regarding persistent maternal tachycardia are presented for midwives and doctors caring for pregnant women.

Authors' affiliations

N F Moran, KwaZulu-Natal Department of Health; Department of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

O P Khaliq, Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of the Free State, Bloemfontein, South Africa

N C Ngene, Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Obstetrics and Gynecology, Leratong Hospital, Krugersdorp, South Africa

J Moodley, Women’s Health and HIV Research Group, Department of Obstetrics and Gynecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa