Cardiac disease during pregnancy--a Free State perspective on maternal morbidity and mortality

Abstract

Aim: Description of maternal outcome of pregnancies complicated by cardiac disease.

Setting: Pelonomi Hospital, Bloemfontein.

Population: Black African women of low socio-economic background who presented with cardiac disease during pregnancy.

Sample: All patients who delivered from 1 January 1990 to 1 January 1995.

Design: Descriptive retrospective study.

Results: Cardiac disease complicated 0.6% of pregnancies. Rheumatic valvular disease dominated in this population. The maternal mortality rate was 9.5% while the maternal morbidity rate ranged from 50% to 100% for the various lesions.

Conclusions: Cardiac disease in pregnancy has high maternal mortality and morbidity rates. Hypertension, anticoagulation therapy, late referrals and inadequate counselling were important contributing factors. A high priority should be given to meticulous contraceptive counselling in patients with cardiac disease. Collaboration between obstetricians, physicians and cardiothoracic surgeons in imperative.