Epidemiology of Cardiac Disease during Pregnancy in Khartoum Hospital, Sudan

Abstract

Data was collected prospectively during the period of May 2011-through December 2012 at Khartoum Teaching Hospital from 75 pregnant women with heart diseases to investigate the epidemiology of cardiac disease in pregnancy. Means and proportions were calculated using student and X2 test, respectively. Univariate and multivariate analyses were performed, confidence intervals of 95% were calculated and P<0.05 was considered significant. With regard to classification of the cardiac disease, 60%, 26.7% and 13.3% was rheumatic heart disease, congenital heart disease and other acquired heart disease respectively. Ten cases were ended with therapeutic and spontaneous miscarriage and 65 cases reached viability. The reported medical problems that complicated the pregnancy of our patients included: congestive heart failure (14/75, 18.6%), arrhythmias (6/75, 8%), pulmonary embolism (4/75, 5.3%) and pulmonary oedema (2/75, 2.6%). There were two cases of maternal mortality (2.7%). In this study maternal cardiac complication were more common among women with past medical history of cardiac complication (OR=1.0; CI=, 1.0-1.0; P =0.023), NYHA class III & IV at booking (OR=15.9; CI=, 2.8-38; P =0.000), mitral stenosis without other valvular lesion (OR=5.3; CI=, 1.0-25.1; P =0.021), cardiomyopathy (OR=10; CI=, 1.1-88.6; P =0.036) and those without preconception counselling (OR=2.4; CI=, 1.3-4.2; P =0.002). Cardiac surgery prior to pregnancy did not guarantee a complication-free course in subsequent pregnancies. Thus Rheumatic heart disease is the most dominant aetiology of heart disease during pregnancy in Sudan. Cardiac surgery prior to pregnancy is not a grantee for pregnancy free complication.