The reported incidence of heart disease in pregnancy in the south-east Asiatic developing countries varies from 0.1% – 0.6%. This account for less than 5% maternal mortality which can be further lowered by good obstetric care.
Types of Cardiac Lesions in Pregnancy.
Acquired lesions: Rheumatic heart disease accounts for about 90 percent of all cases in pregnancy. There are valvular lesions with myofibrosis of the heart. Of these, mitral stenosis is the commonest lesion. However incidence of rheumatic heart disease has fallen because of the use of antibiotics in Western countries.
Congenital lesions: Congenital heart disease (patent interatrial or intraventricular septal defect, patent ductus arteriosus, aortic coarctation, pulmonary stenosis - all usually without cyanosis, a few following corrective surgery) accounts for about another 10 percent.
Other: Rare lesions are those of thyrotoxic, syphilitic, hypertensive and coronary heart disease. Cardiomyopathy is a rare condition of myocardial failure of unknown aetiology and uncertain pathology occurring in puerperium or late pregnancy.
N.B. Severe anaemia in tropics is an important cause of cardiac failure in pregnancy.
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