Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening Study.

Journal Article (Journal Article)

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 prevalence 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 outcome 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.

Full Text

Duke Authors

Cited Authors

  • Snelgrove, JW; Alera, JM; Foster, MC; Bett, KCN; Bloomfield, GS; Silversides, CK; Barasa, FA; Christoffersen-Deb, A; Millar, HC; Thorne, JG; Spitzer, RF; Vedanthan, R; Okun, N

Published Date

  • February 9, 2021

Published In

Volume / Issue

  • 16 / 1

Start / End Page

  • 10 -

PubMed ID

  • 33598390

Pubmed Central ID

  • PMC7879998

Electronic International Standard Serial Number (EISSN)

  • 2211-8179

Digital Object Identifier (DOI)

  • 10.5334/gh.826

Language

  • eng

Conference Location

  • England