Maternal and Perinatal Outcomes of Pregnant Women with Heart Disease in Three Yaoundé Referral Hospitals

Abstract

Heart disease in pregnancy is the cause of significant maternal and perinatal morbidity. We wanted to evaluate the maternal and perinatal outcomes of pregnant women with heart disease in Yaoundé, Cameroon. This was a cross sectional study with retrospective data collection of 45 pregnancies in 42 women with heart disease followed at three Yaoundé referral hospitals in Yaoundé, Cameroon from January 1 st 2015 to December 31 st 2020. We collected data on maternal obstetrical and perinatal outcomes. The frequency of pregnancies with heart diseases was 0.1%. The mean maternal age was 29.05 ± 6.5 years. At first antenatal visit, all patients were in class I (84.4%) and II (15.6%) of the New-York Heart Association (NYHA) functional class. Valvular heart disease (51.1%) was the most common type followed by cardiomyopathy (37.7%). Over half of the deliveries were vaginal (51.1%). A cesarean section was generally indicated for the usual obstetrical reasons (54.5%) and for heart disease (31.8%). Complications included 17 (37.7%) cases of heart failure, 6 (13.3%) cases of pulmonary edema, 2 (04.4%) cases of pulmonary embolism, 3 (06.6%) maternal deaths and 3 (06.3%) perinatal deaths, 14 (29.7%) premature births and 3 cases of (6.3%) intrauterine growth retardation. The maternal deaths were cases complicated by pulmonary edema and all had dilated cardiomyopathy. The maternal and perinatal outcomes of pregnant women with heart disease are marked in our environment by increased morbidity and mortality. Therefore, it is necessary to improve the prenatal, per partum and postpartum management of this high-risk group.

A clinical study of perinatal and maternal morbidity and mortality in gestational hypertension, preeclampsia and eclampsia

“…The disparity between the results may be due to the severity of the disease, early induction of labour and because of unbooked cases that came late in pregnancy. The maturity of the baby in this study was preterm 30, and term babies are 74, which is similar to the study of Doddamani et al [17] The present study is similar to the study of J.D.K.Ngowa et al [18] but more than Edgar M Ndaboine et al [9] due to lack of regular antenatal checkups, complicated cases of preeclampsia, lack of awareness regarding the significance of symptoms like decreased foetal movements, late arrival at the hospital.…”

“…The present study was less compared to the study conducted by J. D. K Ngowa et al [18] due to effective neonatal care in NICU with good backup by efficient paediatricians bringing out better foetal outcomes. All patients who were diagnosed to have preeclampsia before 34 weeks had the worst prognosis.…”

“…In the study by Shanti Yadav (1997) incidence of perinatal mortality was 13.4 %. Perinatal mortality study conducted by Edgar.M Ndaboine [9] 20.7 % {2012} Perinatal mortality study conducted by J. D. K Ngowa et al [18] was 55.6 % in the year 2015.…”