Heart disease in pregnancy\u2014clinical pattern and prevalence: initial data from the first cardio-maternal unit in Iraq

Hasan Ali Farhan,Israa Fadhil Yaseen

doi:10.1186/s13104-019-4523-6

Abstract

ObjectivesThe purpose of this study to determine the clinical pattern and prevalence of heart disease in pregnancy at the first established cardio-maternal unit in Iraq over the last 4 years; since January 2015 till May 2019. Data are presented as number and percentage.ResultsA total of 252 pregnant women presented to cardio-maternal unit included in this study. According to the collected data, among the main diagnosis of heart disease during pregnancy was valvular heart disease 34.1%, followed by congenital heart disease 30.5%, cardiomyopathy 29.8%, pulmonary hypertension 4%, and ischemic heart disease 1.6%. Among subtypes of the main heart diseases in pregnant women, the most clinical pattern was: the prosthetic heart valve (26.7%) in valvular heart disease, both atrial septal defect and ventricular septal defect (35%) in congenital heart disease, and peripartum cardiomyopathy (76%) among cardiomyopathies.

Highlights

Cardiovascular disease (CVD) in women is associated with 4% complications during their pregnancy and is the most frequent leading cause of maternal mortality reaching up to 15% [1–4]
After 2010, the rate of maternal mortality mainly in emerging countries began to decline, despite increasing numbers of high-risk patients [2]. This decline may be related to improvement in medical service; which generally includes cardiologist, obstetrician, and anesthetist, following European Society of Cardiology guidelines for management of CVD during pregnancy, and registration of patients’ data which is improving significantly in the emerging countries as it was shown while comparing data from PREG1 and PREG2 cohorts (21.3% vs 45.3%); PREG1 and PREG2 cohort data were collected from the main international “Registry Of Pregnancy And Cardiac disease” which was established by the EURObservational Research Programme of the European
Prosthetic heart valve and mitral stenosis (MS) were predominate among pregnant women with valvular heart disease (VHD), and it is very important to focus on these subtypes of heart disease (HD) as prosthetic heart valve and MS are associated with high maternal and fetal complications, in addition, MS is considered as the most common leading cause for maternal mortality in patients with VHD in emerging countries especially postpartum mortality because it is poorly tolerated during pregnancy [3, 4, 9, 11–13]

Summary

Introduction

Cardiovascular disease (CVD) in women is associated with 4% complications during their pregnancy and is the most frequent leading cause of maternal mortality reaching up to 15% [1–4]. After 2010, the rate of maternal mortality mainly in emerging countries began to decline, despite increasing numbers of high-risk patients [2] This decline may be related to improvement in medical service; which generally includes cardiologist, obstetrician, and anesthetist, following European Society of Cardiology guidelines for management of CVD during pregnancy, and registration of patients’ data which is improving significantly in the emerging countries as it was shown while comparing data from PREG1 and PREG2 cohorts (21.3% vs 45.3%); PREG1 and PREG2 cohort data were collected from the main international “Registry Of Pregnancy And Cardiac disease” which was established by the EURObservational Research Programme of the European. We will demonstrate for the first time the clinical pattern and prevalence of heart disease (HD) in pregnant women presented to the first established cardio-maternal unit in Iraq over 4 years, this will encourage to spread the registration nationally and internationally leading to improve prevention, diagnosis and management of HD during pregnancy

Objectives

Results

Discussion

Conclusion