The Pan-African Society of Cardiology position paper on reproductive healthcare for women with rheumatic heart disease

Abstract

This position paper summarises the current knowledge on the epidemiology, diagnosis and management of women of childbearing age with rheumatic heart disease (RHD) in Africa, as well as the available data on their use of reproductive health services. The aim is to provide guidance to health professionals on aspects of sexual and reproductive health in women with RHD. It reviews the diagnosis, management and counselling of women with RHD throughout their reproductive life. Additionally, this publication discusses potential ways of integrating obstetric and cardiovascular care at peripheral levels of the health systems, as a way of improving outcomes and reducing maternal mortality rates related to cardiovascular disease in Africa. Finally, the article proposes responses to fulfil the actual needs for better reproductive health services and improvement in care for women with RHD.

Keywords: cardiovascular disease; rheumatic heart disease; sexual and reproductive health.

Fig. 1

Estimated WHO prevalence of rheumatic heart disease per 1 000, fertility rate, maternal mortality rate and contraceptive prevalence in African countries, grouped by region (southern, northern, central, western and eastern). Prevalence by echo screening (where available from community-based studies) is per 1 000.

Fig. 2

Type of contraceptives that can be used by females and males, indicating the most recommended.

Fig. 3

Referral algorithm recommended for screening and management of women with suspected or known cardiovascular disease at primary and secondary level of care.