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Title: | Prevalence of rheumatic heart disease and other cardiac conditions in low-risk pregnancies in Kenya: A prospective echocardiography screening study |
Authors: | Snelgrove, John W. Alera, Joy Marsha Foster, Michael C. Bett, Kipchumba C. N. Bloomfield, Gerald S. Silversides, Candice K. Barasa, Felix A. Christoffersen-Deb, Astrid Millar, Heather C. Thorne, Julie G. Spitzer, Rachel F. Vedanthan, Rajesh Okun, Nanette |
Keywords: | Rheumatic heart disease Pregnancy Echocardiography Epidemiology |
Issue Date: | 9-Feb-2021 |
Publisher: | PMC |
Abstract: | Background: Rheumatic heart disease (RHD) in sub-Saharan Africa contributes to significant cardiac morbidity and mortality, yet prevalence estimates of RHD lesions in pregnancy are lacking. Objectives: Our first aim was to evaluate women using echocardiography to estimate the prev- alence of RHD and other cardiac lesions in low-risk pregnancies. Our second aim was to assess the feasibility of screening echocardiography and its acceptability to patients. Methods: We prospectively recruited 601 pregnant women from a low-risk antenatal clinic at a tertiary care maternity centre in Western Kenya. Women completed a questionnaire about past medical history and cardiac symptoms. They underwent standardized screening echocardiography to evaluate RHD and non-RHD associated cardiac lesions. Our primary out- come was RHD-associated cardiac lesions and our secondary outcome was a composite of any clinically-relevant cardiac lesion or echocardiography finding. We also recorded duration of screening echocardiography and its acceptability among pregnant women in this sample. Results: The point prevalence of RHD-associated cardiac lesions was 5.0/1,000 (95% confidence interval: 1.0–14.5), and the point prevalence of all clinically significant lesions/findings was 21.6/1,000 (11.6–36.7). Mean screening time was seven minutes (SD 1.7, range: 4–17) for women without cardiac abnormalities and 13 minutes (SD 4.6, range: 6–23) for women with abnormal findings. Echocardiography was acceptable to women with 74.2% agreeing to participate. Conclusions: The prevalence of clinically-relevant cardiac lesions was moderately high in a low- risk population of pregnant women in Western Kenya. |
URI: | https://doi.org/10.5334/gh.826 http://ir.mu.ac.ke:8080/jspui/handle/123456789/6832 |
Appears in Collections: | School of Medicine |
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