Introduction
Women with pre-existing heart disease have a higher risk of developing complications and suffering poor outcomes, both during and after pregnancy. Optimal management for heart disease during pregnancy is poorly defined, with treatment varying significantly across sites. Our combined retrospective and prospective approach to studying this population aims to inform the ideal process for management and treatment of pregnant women with heart disease.
Methods
Participants were retrospectively identified through ICD coding for inclusion into the study. All patients with a diagnosis of pre-existing heart disease who received antenatal care at our tertiary care centre between 2013 and 2017 were included in the retrospective audit. These participants will also be contacted for consent into the prospective registry to monitor long-term outcomes. All women with a diagnosis of heart disease receiving antenatal care are asked to participate in our prospective study.
Results
We identified more than 700 patients with ICD codes indicating a diagnosis of heart disease. A preliminary analysis of 25 participants revealed that structural heart disease and arrhythmia were the most common diagnoses (56% and 24%, respectively) and that clinical management varied considerably between patients. More than half (56%) of participants developed a pregnancy or birth complication.
Conclusion
The Cardiac-Obstetric Registry of South Australia intends to monitor outcomes of pregnant women with a diagnosis of heart disease. Project outcomes will inform our clinical management of these women at our site and, in the future, within our state. Long-term follow-up will also improve access to care for these high-risk women and their children.