Factors Related to Maternal Adverse Outcomes in Pregnant Women with Cardiac Disease in Low-resource Settings

Abstract

Background: Cardiac disease is an important life-threatening complication during pregnancy. It is frequently seen in pregnant women living in resource-limited areas and often results in premature death. Aim: The aim of this hospital-based longitudinal study was to identify factors related to adverse maternal and neonatal outcomes in pregnant women with cardiac disease in low-resource settings. Methods: The study enrolled 91 pregnant women with congenital or acquired cardiac disease over a period of 2 years in Kenya. Results: Maternal and early neonatal deaths occurred in 12.2% and 12.6% of cases, respectively. The risk of adverse outcomes was significantly increased in those with pulmonary oedema (OR 11, 95% CI [2.3–52]; p=0.002) and arrhythmias (OR 16.9, 95% CI [2.5–113]; p=0.004). Limited access to care was significantly associated with adverse maternal outcomes (p≤0.001). Conclusion: Many factors contribute to adverse maternal and neonatal outcomes in pregnant women with cardiac disease. Access to comprehensive specialised care may help reduce cardiac-related complications during pregnancy.

Comparison of maternal and fetal outcomes in mothers with non-congenital mitral valve stenosis and healthy control

“…The rate of pulmonary edema in our study was 13.7% which was similar to that of P. A. Poli et al [33] (16.7%) and J. Relmasira et al [34] (11.1%). However, significantly higher rates of pulmonary edema were reported by Silverside et al [36] (31.25%) and Desia et al [37] (35%).…”

“…On the Other hand, Samii et al [32] found that the NYHA class changed during pregnancy in 26.3% of patients, mostly in the third trimester. ICU admission was 23.5% in the present study compared with 6.3% in Pilo et al's study [33] , which can be related to the proportion of patients with severe MS. In our study, pulmonary hypertension was seen in 9.8% of pregnant women with MS, which was similar to that of J. Relmasira et al [34] (8.3%) and Pilo et al [25] (10.5%).…”

Cardiac disease in pregnancy

“…in this setting, 80% delivered vaginally, 18.5% had undergone C-section and 4.6% underwent termination of pregnancy for miscarriage. 5 In our study, from 12 cases one was diagnosed during intra-partum, one was diagnosed in post-partum period while rest of the cases were identified in ante-natal period.…”

Maternal and Neonatal Outcomes in Pregnant Patients with Pre-Existing Cardiac Diseases

“…7,12,15 A study published in European Cardiology Review (ECR) by Poli et al reported maternal death to be slightly higher at 12%. 16 Causes of death were acute pulmonary edema and congestive cardiac failure. In maternal mortality, highest incidence of death was in patients of dilated and peripartum cardiomyopathies.…”