Abstract:
OBJECTIVE : TO STUDY THE CHANGES IN THE PATTERN OF
HEART DISEASE IN PREGNANCY OVER THE PAST FOUR DECADES
IN A SRI LANKAN CENTRE.
METHOD : The data of pregnant mothers with heart
disease attending the University Obst & Gynae Unit
frem '93—'97 were analyzed prospectively.
Echocardiography was performed on al l subjects;
cardiac and Obstetric complications and pregnancy
outcome were recorded.
The data was compared with that published from the
same clinical department over the past four decades.
RESULTS : In the decades
1
50c -'60s and '70s the *
incidence was less than 1% while i t was 2.01% and 2.5%
in the '80s and '90s respectively. MVP has been
recognized from the '80s and caused a decline in the
prevalence of rheumatic heart disease from 74% in '70s
to 51% in the '80s . Rheumatic heart disease however
showed an independant decline throughout the study
period. Maternal deaths were absent in the '60s and
'70s while in the '80s i t has been 1.7% and 1.3% in
the last two decades. This is due to a higher rate of
pregnancy in women with very serious heart disease.
CONCLUSIONS : Future programs should include screening
in adolescence and premarital and pre-pregnancy
councelling
