Cardiac diseases in pregnancy: A 10-year review in a tertiary hospital in South-west Nigeria

Abstract

Background: The superimposition of the morbidity of cardiac diseases on the physiological demands of pregnancy could impact adversely on pregnancy outcomes. Therefore, contemporary information is for appropriate clinical management. Objective: To determine the management outcomes of cardiac diseases in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife. Methods: A retrospective review of the hospital records of patients with cardiac diseases in pregnancy between January 2006 and December 2015 was conducted. The age, parity, gestational age at admission, NYHA class, clinical diagnosis, the results of investigations, complications of cardiac diseases, and maternal and foetal outcomes were recorded. Results: There were 33 women with cardiac diseases in pregnancy and 11,352 deliveries within the period, giving an incidence of 2.9 per 1000. Further analysis was based on 24 women with complete records. The mean age of the patients was 29.2±5.5 years. Twenty (83%) of the women were Para 2 or less, while 13 (54%) presented postpartum. The majority of the women (15; 62.5%) had peripartum cardiomyopathy, while 17 (71%) had NYHA Class III or IV disease. Thirteen (54%) women had vaginal delivery. There were four perinatal and two maternal deaths, with a perinatal mortality rate of 166/1,000 total births and maternal mortality ratio of 8,333/100,000 live births. Conclusion: Cardiac diseases in pregnancy are associated with high perinatal and maternal mortality rates at the OAUTHC, Ile-Ife. However, with early diagnosis and appropriate care, the majority of the patients had a satisfactory clinical outcome. Early presentation and advocacy to improve health-seeking behaviour are recommended.

Keywords

• cardiac diseases
• heart failure
• peripartal cardiomyopathy
• pregnancy