Original articles

Cardiac Disease in Pregnancy - a four-year audit at Pretoria Academic Hospital (2002-2005)

Priya Soma-Pillay, Angus Peter Macdonald, Tshimbi Mathivha, Janine Bakker, Mattessa Mackintosh

Abstract


Background. Pre-existing medical disease constitutes one of the 5 major causes of maternal death in South Africa. Increasing numbers of women with heart disease are reaching adulthood as a result of advances in diagnoses and treatment of heart disease in childhood.
Objective. To assess the profile of cardiac disease and the maternal and fetal outcome of pregnant patients at Pretoria Academic Hospital (PAH).
Methods. A retrospective analysis was carried out on 189 pregnant cardiac patients who delivered at PAH between January 2002 to December 2005.
Results. Almost 1% of all patients delivered at PAH had underlying cardiac disease. Most of the cardiac lesions were valvular disease secondary to childhood rheumatic heart disease. Pulmonary oedema was associated with the greatest morbidity and mortality. The severe morbidity rate was 11.6% and the case fatality rate, 3.3%. The mean gestational age at delivery was 35 weeks and 18 (9.7%) babies were born before 34 weeks.
Conclusion. Cardiac disease in pregnancy is associated with high morbidity and mortality rates for both mothers and their babies. Multi-disciplinary pre-conceptual evaluation with discussion of risk factors, appropriate family planning and optimising the cardiac state before conception is advised.

Authors' affiliations

Priya Soma-Pillay, University of Pretoria

Angus Peter Macdonald, University of Pretoria

Tshimbi Mathivha, University of Pretoria

Janine Bakker, Vrije University

Mattessa Mackintosh, Vrije University

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Keywords

Pregnancy; Cardiac disease

Cite this article

South African Medical Journal 2008;98(7):553.

Article History

Date submitted: 2007-06-26
Date published: 2008-07-09

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