Balieva, I. (Irina) (2019) Cardiac Disease in Pregnancy: A 1-Year retrospective review of management during pregnancy and maternal and neonatal outcomes from a tertiary hospital in Johannesburg, South Africa. thesis, Medicine.
Full text available on request.Abstract
Introduction: Cardiac disease in pregnancy contributes to morbidity and mortality for both mother and child. In South Africa, rheumatic heart disease, repaired or unrepaired congenital heart disease, hypertensive heart disease and cardiomyopathies are most common. This review aims at presenting management, outcomes and complications of cardiac disease in pregnancy in a Black African population in a resource constrained setting. Methods: A retrospective review of the patient files of all women with cardiac disease delivering at Charlotte Maxeke Johannesburg Academic Hospital, South Africa, from January 1st – December 31st, 2017 was performed. Descriptive statistics were performed. Results: The patient files of 75 women were included. Rheumatic heart disease was the most prevalent diagnosis, followed by congenital heart disease, pulmonary hypertension, and cardiomyopathies. The mean week of presentation was at 17 weeks of gestation and five women had no antenatal care appointment prior to delivery. Any cardiac complication was seen in 43 (57.3%) of the patients, of which 24 (55.8%) were a major adverse cardiac event, and 30 (40%) patients had any obstetric complication. There was one maternal death, two perinatal mortalities and 11 elective or spontaneous abortions. Prematurity (<37 weeks of gestation) was seen in 23 (36.5%) of the babies. Conclusion: There was a high rate of cardiac and obstetric complications in this group of pregnant women in urban South Africa. Most women with cardiac disease can undergo pregnancy with good outcomes, but a multidisciplinary team is necessary. Late presentation, high prevalence of comorbidities and socioeconomic factors seem to contribute to poor outcomes. Pre-conceptual counselling is essential. More research is needed to contribute to evidence based protocols.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Voors, Prof. A. A. MD and University Medical Centre Groningen, Department of Cardiolog |
| Supervisor name: | Second supervisor (South Africa): and Rhemtula, Dr. H. A. MB BCh and University of the Witwatersrand, Johannesburg and Charlotte Maxeke Johannesburg Academic Hospital, Department and Gynaecology |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:58 |
| Last Modified: | 25 Jun 2020 10:58 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1827 |
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