Perinatal Outcome in Pregnant Women with Heart Disease Attending a Combined Obstetric and Cardiology Clinic in a Resource Limited Country

Abstract

Previously published literature has shown a clear relationship between adverse perinatal outcome and the presence of maternal heart disease even when demographic and obstetric risk factors have been taken into account. Prospective studies from South Africa or Africa describing pregnancy outcome in mothers with heart disease, where there is a high prevalence of acquired rheumatic heart disease as well as cardiomyopathies and congenital heart lesions, are limited. Perinatal data were collected to describe the perinatal outcome in patients with heart disease.

Objectives: The purpose of this study was to describe the perinatal outcome of pregnancies in women with heart disease attending a multidisciplinary clinic and to compare the perinatal mortality rate with the perinatal mortality rate for the background population. To determine whether there are any other associated adverse outcomes in babies born to mothers with heart disease.

Methods: The first eighty-two consecutive pregnant patients with heart disease attending the weekly combined cardiology and obstetric clinic were studied over eighteen months. Neonatal outcome was recorded. Adverse neonatal outcome was defined as perinatal mortality, the need for delivery room resuscitation and admission to neonatal intensive care unit (NICU).

Results: Perinatal mortality was 12.1 per 1000 live births. Only one stillbirth was documented. Adverse neonatal outcome was 9.7%. Caesarean section rate was 40% with 29% of infants delivered preterm.

Conclusion: Perinatal mortality rate in this cohort was excellent - possibly due to a high level of joint care - but was linked to a high rate of obstetric intervention.