PMID- 27326158
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160621
LR  - 20201001
IS  - 1759-1104 (Print)
IS  - 1759-1104 (Electronic)
IS  - 1759-1104 (Linking)
VI  - 6
IP  - 1
DP  - 2014
TI  - Pregnancy complicated by heart disease in Nepal.
PG  - 26-9
LID - 10.1136/heartasia-2013-010396 [doi]
AB  - OBJECTIVE: To investigate the prevalence, characteristics and maternal and 
      perinatal outcomes of pregnancies complicated by heart disease. DESIGN: 
      Prospective single-centre registry. SETTING: Tertiary care teaching hospital in 
      eastern Nepal. PATIENTS: Pregnant women presenting to the antenatal clinic and/or 
      labour room between 1 March 2012 and 31 March 2013. MAIN OUTCOME MEASURES: 
      Prevalence, characteristics, and maternal and perinatal outcomes of pregnancies 
      complicated by heart disease. RESULTS: Fifty-three out of 9463 pregnancies (0.6%) 
      were complicated by cardiac disease. Proportions of acquired, congenital and 
      arrhythmic heart disease amounted to 89%, 9% and 2%, respectively. Rheumatic 
      heart disease (RHD) was the most frequent cardiac disease complicating pregnancy 
      (n=47). Among 45 women with RHD continuing pregnancy until delivery, 30 (67%) 
      were primigravidae. The predominant valvular pathology was mitral stenosis (62%), 
      followed by mitral regurgitation (21%) and aortic regurgitation (13%). Twenty 
      women (44%) underwent elective or emergency caesarean section. Maternal and 
      fetal/perinatal mortality of pregnancies complicated by RHD amounted to 4% and 
      16%, respectively. New York Heart Association (NYHA) functional class III or 
      class IV (HR 6.0, 95% CI 1.2 to 29.1, p=0.026), pulmonary hypertension (HR 9.1, 
      95% CI 1.6 to 51.5, p=0.012) and severe mitral stenosis (HR 7.0, 95% CI 1.4 to 
      34.4, p=0.017) were identified as predictors of maternal or fetal/perinatal 
      mortality in an univariate analysis. CONCLUSIONS: Rheumatic mitral stenosis was 
      the most frequent heart disease complicating pregnancy in a consecutive cohort 
      from a teaching hospital in Nepal. Exercise intolerance, pulmonary hypertension 
      and severe mitral stenosis were identified as predictors of maternal or 
      fetal/perinatal mortality.
FAU - Chhetri, Shailaja
AU  - Chhetri S
AD  - Department of Obstetrics & Gynecology , BP Koirala Institute of Health , Dharan , 
      Nepal.
FAU - Shrestha, Nikesh Raj
AU  - Shrestha NR
AD  - Department of Cardiology , BP Koirala Institute of Health , Dharan , Nepal.
FAU - Pilgrim, Thomas
AU  - Pilgrim T
AD  - Department of Cardiology , Bern University Hospital , Bern , Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20140220
PL  - England
TA  - Heart Asia
JT  - Heart Asia
JID - 101542742
PMC - PMC4832684
EDAT- 2014/01/01 00:00
MHDA- 2014/01/01 00:01
PMCR- 2014/02/20
CRDT- 2016/06/22 06:00
PHST- 2013/07/26 00:00 [received]
PHST- 2013/10/23 00:00 [revised]
PHST- 2014/01/24 00:00 [accepted]
PHST- 2016/06/22 06:00 [entrez]
PHST- 2014/01/01 00:00 [pubmed]
PHST- 2014/01/01 00:01 [medline]
PHST- 2014/02/20 00:00 [pmc-release]
AID - heartasia-2013-010396 [pii]
AID - 10.1136/heartasia-2013-010396 [doi]
PST - epublish
SO  - Heart Asia. 2014 Feb 20;6(1):26-9. doi: 10.1136/heartasia-2013-010396. 
      eCollection 2014.