TITLE:
Prognosis of Pregnancy and Childbirth in Heart Operated Patients: Experience in a 3 Referral Hospital in Mali, Case of the Gabriel University Hospital in Bamako
AUTHORS:
Fané Seydou, Sanogo Siaka Amara, Bocoum Amadou, Sylla Checkna, Kante Ibrahima, Traore Youssouf, Tegueté Ibrahima, M. Traoré, Mounkoro Niani, A. Dolo
KEYWORDS:
Cardiac Surgery, Pregnancy, Prognosis
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.12,
December
31,
2021
ABSTRACT: Introduction: In sub-Saharan Africa and Mali, young women who have had heart surgery
want to become pregnant. The occurrence of pregnancy in these women who have
had heart surgery is becoming more and more frequent in our country because of
the persistence of acute rheumatoid arthritis (RAA) and especially the increasingly easy access to heart surgery. General
Objective: To study the evolution of pregnancy and the prognosis of
childbirth in women who have undergone heart surgery. Methodology: This
was a retrospective and descriptive study that took place over a period of five
(5) years in the gynecology-obstetrics department of University Teaching
Hospital (UTH) Gabriel Touré and the cardiology department of UTH Luxembourg.
Was included in the study any pregnant woman admitted to the
gynecology-obstetrics department of UTH Gabriel Touré and having a history of
heart surgery. The variables studied were the socio-demographic
characteristics, the type of heart disease, the management, the evolution of
the pregnancy and the prognosis. Data was typed on word processor, Excel and
analyzed on Epi info and SPSS. The Chi square or Fisher exact test (for the
number to 5) and the relative risk (RR) with confidence interval (CI) to 95% were
calculated. P was considered as significant if . Results: Of the 13,388
pregnant women admitted to the gynecology/obstetrics department of UTH Gabriel
Touré, 20 pregnant women had a history of heart surgery (1.49‰). The average
age was 26 years old. The main cardiac pathology was valvular heart disease
supported in 80.00% by the placement of a prosthesis. During pregnancy
follow-up, 55% of pregnant women were on Anti-Vitamin K (AVK). In 95.00% of
cases, heart disease was asymptomatic. We reported a case (5.00%) of iterative
cardiac decompensation, in which cardiac
ultrasound found a very arrhythmic heart, grade III mitral leak, and massive
aortic leak. We did not find any case of prosthetic thrombosis. The abortion
rate was 5.00%. The caesarean section rate was 31.60% and the instrumental
extraction rate (forceps) was 23.10%. Newborns had a normal birth weight
(68.40%), and were hypotrophic (15.80%) and premature (15.80%). In pregnant
women on AVK, we reported 2 cases of fetal deaths in utero (10.00%). Conclusion: Surgical treatment of operable heart disease is a real prophylaxis for
gravidocardiac accidents. Pregnancy can be well tolerated in patients who
underwent heart surgery with artificial heart valves.