Pregnancy in women with heart disease in sub-Saharan Africa

Diao, Maboury; Kane, Adama; Ndiaye, Mouhamadou Bamba; Mbaye, A.; Bodian, Malick; Dia, Mouhamadoul Mounir; Sarr, M.; Kané, A.; Monsuez, Jean‐Jacques; Bâ, Serigne Abdou

doi:10.1016/j.acvd.2011.04.001

Cited by 134 publications

(93 citation statements)

References 10 publications

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“…Prosthetic valve patients tolerated pregnancy well and prosthetic valve on anticoagulant was not a risk factor, as seen in some studies. [8][9][10] There was no maternal mortality in our study population whereas other studies have reported maternal mortality in heart disease in pregnancy. NYHA functional class and CARPREG Risk score were validated in our study as predictors for adverse maternal outcome Our study had more adverse maternal outcome than CARPREG study, having incidence of adverse maternal outcome as 21.4%, 46.1% and 100% (Table 1) as compared to 1%, 27% and 75% found by Siu et al, in score 0, 1 or ≥2 respectively.…”

Section: Risk Factors For Adverse Maternal Outcomecontrasting

confidence: 51%

Risk factors in pregnancy with heart disease and their co-relation with adverse feto-maternal outcome

Sharma¹,

Malik²,

Pandit³

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Heart disease complicates 1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. In India, the predominant heart disease is still RHD (rheumatic heart disease), whereas in the developed countries congenital heart disease is more common.Methods: This prospective observational study conducted in Department of Obstetrics and Gynecology in carried in PGIMER and Dr. RML Hospital, New Delhi from November 2015 to March 2017. 35 patients with heart disease were included in this study eight risk factors, four non-cardiac (age, parity, BMI and time of reporting to hospital) and four cardiac risk factors (etiology of lesion, type of lesion, prosthetic valve on anticoagulation and associated cardiac complication like atrial fibrillation (AF), pulmonary edema, pulmonary artery hypertension (PAH) were co-related with predefined indicators for adverse feto-maternal outcome. NYHA class, CARPREG score, modified WHO class were also co-related with adverse feto-maternal outcome.Results: RHD is still more common than CHD in our population. No association was seen between any non-cardiac risk factor and adverse maternal outcome. Among cardiac risk factors, severe MS, severe PAH, NYHA class IV, AF, CARPREG score ≥2 were significantly associated with adverse maternal and fetal outcome. There was no maternal or fetal death in the present study.Conclusions: Severe MS, severe PAH, AF, NYHA Class IV, CARPREG score ≥2 had positive predictive value for adverse feto maternal outcome in the present study which had no maternal or fetal mortality. Need for Preconceptional counselling which was seen to be totally absent in the present study is emphasized.

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Section: Risk Factors For Adverse Maternal Outcomecontrasting

confidence: 51%

Risk factors in pregnancy with heart disease and their co-relation with adverse feto-maternal outcome

Sharma¹,

Malik²,

Pandit³

2018

Int J Reprod Contracept Obstet Gynecol

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“…15 Mitral regurgitation was the second commonest lesion similar to other studies. 3,16 It is well tolerated during pregnancy and mild regurgitation poses a low risk of complications. 17 A recent Brazilian study however reported that cardiac adaptations in women with mitral regurgitation are dissimilar from normal women and optimal cardiac remodeling does not occur in these patients.…”

mentioning

confidence: 99%

“…23 In an African study, pulmonary edema was present at admission in 36 out of 50 patients and there were 17 maternal deaths. 16 Cesarean section was performed for obstetric indication in 20.6% patients. In contrast, a similar study in South Africa reported 16.66% elective cesarean sections for severe heart disease.…”

mentioning

confidence: 99%

Clinical profile and obstetric outcome in pregnancies complicated by heart disease: a five year Indian rural experience

Bagde

Shivkumar

et al. 2013

Int J Reprod Contracept Obstet Gynecol

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“…Data from Ethiopia show higher mortality in women, with female deaths accounting for 57.4% of the 115 cases studied 27. Diao et al 14 recently reported 17 maternal deaths in a series of 46 women (34%) from Cameroon with rheumatic heart valve disease, of which 32 had mitral stenosis. Maternal death was associated with mitral stenosis, severe tricuspid regurgitation and New York Heart Association functional class III/IV.…”

Section: Propensity To Heart Diseasementioning

confidence: 99%

“…Even when surgery is available, the choice between repair or replacement can be difficult. In a small series from Cameroon, women with prior surgical valve replacement had a better prognosis 14. However, mitral repair and aortic valve replacement with pulmonary autograft (Ross procedure) are the preferred procedures to manage left heart valve disease in young girls because they allow continued growth of the aortic valve and avoid long-term anticoagulation.…”

Section: Propensity To Heart Diseasementioning

confidence: 99%

Women's cardiovascular health in Africa

Mocumbi

Sliwa

2012

Heart

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The predominant pattern of cardiovascular diseases in sub-Saharan Africa is that of poverty-related conditions (rheumatic heart valve disease, untreated congenital heart disease, tuberculous pericarditis) and diseases of unclear aetiology with a higher prevalence in this part of the world (peripartum cardiomyopathy, endomyocardial fibrosis). However, the prevalence of the traditional risk factors for cardiovascular diseases such as hypertension and marked obesity is high in a number of sub-Saharan settings, although they vary considerably among countries, urban/rural locations and specific subpopulations. In urban settings, hypertensive heart disease with systolic and diastolic function contributes substantially to morbidity. Awareness of the general public and health workers about the burden of cardiovascular diseases in women must be increased, and risk factor control programmes must be included in the health research agenda on the African continent. Improvement in health services with coordination of maternal health services and non-communicable diseases is also needed. This review focuses on the current knowledge of cardiovascular healthcare of women in sub-Saharan Africa, particularly their propensity for various forms of heart disease, access to healthcare, treatment received within the respective healthcare system, response to therapy and mortality. It highlights the gaps in knowledge and the paucity of data in most of these aspects.

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Pregnancy in women with heart disease in sub-Saharan Africa

Abstract: Heart disease severely impacts maternal and foetal outcome in our study. Pregnant women who underwent appropriate valve replacement before pregnancy had a better prognosis.

Cited by 134 publications

References 10 publications

Risk factors in pregnancy with heart disease and their co-relation with adverse feto-maternal outcome

Risk factors in pregnancy with heart disease and their co-relation with adverse feto-maternal outcome

Clinical profile and obstetric outcome in pregnancies complicated by heart disease: a five year Indian rural experience

Women's cardiovascular health in Africa

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