Profile of obstetric cardiac patients delivered with an anaesthetic intervention at an academic hospital

Lushiku, Lunganga Toms
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Background Pregnant women with cardiac disease present some of the greatest challenges to the anaesthesiologist. Data from South Africa as to the incidence, the type of anaesthetic technique used as well as maternal cardiac and obstetric outcomes of these patients is scanty. Therefore, the aim of this study is to describe the profile of obstetric cardiac patients who delivered with an anaesthetic intervention at Chris Hani Baragwanath Academic Hospital. Methods A retrospective audit using consecutive convenience sampling was done by reviewing the labour ward admission books, the cardiac obstetric anaesthetic assessment forms, the intraoperative anaesthetic forms and the labour epidural forms from January 2014 to December 2015. Results Two hundred and three (0.49%) patients were identified with underlying cardiac disease and 83 met the criteria for inclusion. Acquired cardiac disease was most prevalent (65%) and rheumatic valvular cardiac disease being the most dominant (41%) lesion. Pulmonary hypertension was present in 19% of patients. Eighteen percent of patients were included in mWHO class 4 where pregnancy is not advised. Neuraxial anaesthesia was used in 57% of deliveries. Intraoperative complications were present in 8 (10%) patients. Two (2%) patients had cardiac complications. There was no maternal death recorded in the first 24 hours post-delivery. iv Conclusions This audit demonstrated that acquired cardiac diseases were more prevalent than congenital and rheumatic valvular disease is still the most common cause of acquired cardiac disease in pregnancy. Neuraxial anaesthesia was the most used anaesthetic technique for delivery in these patients
A research report submitted to the faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Anaesthesiology, Johannesburg 2018
Lushiku, Lunganga Toms, Profile of obstetric cardiac patients delivered with an anaesthetic intervention at an academic, University of the Witwatersrand, Johannesburg, <>