Cardiovascular Journal of Africa: Africa STEMI Abstracts (April 2018)

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CARDIOVASCULAR JOURNAL OF AFRICA • Africa STEMI Abstracts, April 2018 10 AFRICA
Presenting Author
Name: Abraha Hailu
Surname: Weldegerima
Email
Contact Number 251911413363
Article
English Title
Outcome of pulmonary hypertension in pregnancy: Experience from resource limited setting in a university hospital in
northern Ethiopia
Category
Heart Failure
English Abstract
Introduction: Pulmonary hypertension (PH) is a rare disease and when associated with pregnancy can be devastating. In
the developed world, maternal mortality from PH has decreased from 56% in the 1970s to 16% as of 2014. In the develop-
ing world, there are still many challenges in the management of these cases.
Objective: to review the management of such patients in a resource limited setting from September 2016 to September
2017.
Methods: Cases with severe PH were identified from high risk antenatal care follow up, cardiology clinic and wards. Sever-
ity and type of pulmonary hypertension, NYHA functional status, mode of delivery and anesthesia as well as neonatal and
maternal outcomes were noted.
Results: 20 cases of severe PH were reviewed. Seventeen of the patients had chronic rheumatic valvular heart disease
(RHD) as the cause of PH (81% Group 2 PH, with average mitral valve area was 0.9sqcm) and 3 had combined RHD
and Congenital Heart Defects (CHD) and one isolated CHD. The average pulmonary arterial pressure as measured on
Echocardiography was 102.9 mmHg (SD 16.9). Fourteen of the patients had NYHA functional class III or more (66.7%), 10
patients underwent cesarean deliveries, 5 underwent vaginal deliveries with assisted second stage Two patients underwent
termination of pregnancy at 16 & 19 weeks and are alive. There were 4 maternal deaths (19.1%) with a mean age at death
of 28 years (SD 5.3). Death was caused by pulmonary edema in 2 cases and pulmonary venous thromboembolism in 2
cases. 76.2% of pregnancies resulted in live birth.
Conclusion: Group 2 PH caused by mitral stenosis complicating pregnancy continues to be a significant contributor in our
set up. Although these cases were managed in a low resource setting, the outcomes are comparable to studies from the
developed world. Multidisciplinary team treatment including cardiology, anesthesia, and obstetrics is important to improve
maternal and fetal outcomes.
Authors
Name &
Surname
Title Expertise Affiliation Email Country
Abraha
Hailu
Dr Internist and
cardiologist
Mekelle University-College of
Health Sciences; Department of
Internal Medicine, Cardiology Unit
Ethiopia
Awol
Yeman Dr
Gynecology and
Obstetrics Resi-
dent
Mekelle University-College of
Health Sciences; Department of
Obstetrics and Gynecology
Ethiopia
Ermias
Abate
Dr Gynecologist and
Obstetrician
Mekelle University-College of
Health Sciences; Department of
Obstetrics and Gynecology
Ethiopia