Characteristics shifting of heart disease in pregnancy: A report from low middle-income country

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  • Cyntia Puspa Pitaloka
    Master Program of Public Health, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia. https://orcid.org/0000-0002-0280-5772
  • Absa Secka
    Master Program of Public Health, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.
  • Ernawati Ernawati
    Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya / Dr. Soetomo General Hospital; Department of Obstetrics & Gynaecology, Airlangga University Academic Hospital, Surabaya, Indonesia.
  • Agus Sulistyono
    Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya / Dr. Soetomo General Hospital, Indonesia.
  • Hermanto Tri Juwono
    Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya / Dr. Soetomo General Hospital, Indonesia.
  • Erry Gumilar Dachlan
    Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya / Dr. Soetomo General Hospital, Indonesia.
  • Aditiawarman Aditiawarman
    Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya / Dr. Soetomo General Hospital, Indonesia.

ABSTRACT

Background: Heart disease in pregnancy is one of the leading causes of maternal mortality and morbidity in developing countries. However, the characteristics of the disease vary between countries and regions. This study aimed to present the characteristics of pregnant women with heart disease in an economically advantageous region of a developing country.
Design and methods: A cross-sectional study was conducted using data from the Weekly Report of Obstetrics and Gynaecology Department to assess pregnant women with heart disease characteristics and pregnancy outcomes. A total sample of 69 pregnant women with heart disease regarding their gestational age was included in the study. Variables observed were maternal characteristics, heart disease's clinical parameters, and maternal and neonatal outcomes. Chi-square test was used to examine the different characteristics of congenital and acquired heart disease groups.
Results: The prevalence of cardiac disease in pregnancy was 5.19%. Fifty-three point six percent of pregnant women with heart disease were suffered from congenital heart disease (CHD), while 46.4% were acquired heart disease (AHD). Most labor methods were Cesarean delivery, and 69.6% of women experienced cardiac complications. Maternal death was reported in 8.69% of cases. Four cases were CHD complicated by pulmonary hypertension, which leads to Eisenmenger syndrome. Two other cases were AHD complicated by Peripartum Cardiomyopathies. Although statistically insignificant, complications are more common in the AHD group than CHD.
Conclusion: Cardiac disease prevalence in pregnancy is considered high, with CHD as the most common case, which significantly differs from other developing countries.

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