الفهرس 
EpidemiologyOnly 14 pages are availabe for public view
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Abstract
Heart diseases during pregnancy is the leading indirect cause of
maternal death all over the world. The incidence of clinically significant cardiac disease during
pregnancy has not changed for decades. The most recent studies report
incidences of 0.1–4%. The spectrum of CVD in Pregnancy is changing and differs
between countries. In the western world, the risk of CVD in
pregnancy has increased due to increasing age at first pregnancy and
increasing prevalence of cardiovascular risk factors—
diabetes,hypertension, and obesity. Also the treatment of congenital
heart disease has improved, resulting in an increased number of
women with heart disease reaching childbearing age. Hypertensive disorders are the most frequent cardiovascular
events during pregnancy, occurring in 6–8% of all pregnancies.
During the study period from 1-1-2012 to 1-1-2013 The number
of pregnant females whom admitted to menoufyia university hospital
and shebin el kom teaching hospital was 4947. The number of pregnant females with heart diseases in
university and shebin el kom teaching hospitals found in that year was
460 cases. 46 cases were diagnosed as native valvular disease, 5 as
prosthetic valvulardisease, 382 cases was diagnosed as hypertensive
heart disease, 26 as cardiomiopathy and one case as congenital heart
disease. Maternal complications occurred in 24 cases of pregnant
females with heart diseases. All babies were scored by APGAR score just after delivery 421
were > 8 and 39 were < 8. One baby delivered stillbirth and 7 were premature.36 babies
were admitted to incubator or mechanical ventilator. 8 babies were dead and the rest were survived after putting on
incubator and mechanical ventilator. In our study the prevelance of prengnancy with cardiovascular
heart diseases was 9.3% (460/4947 ) . Theprevelence of native valvular heart disease in our study was
9 per 1000 and prosthetic valvular heart disease was 1 per 1000. In our study the prevalence of peripartim cardiomyopathy was 5
per 1000. In our study a pregnant female with atrial septal defect was the
only congenital heart disease case found . Pregnant females with hypertensive heart diseases represent
83% of all cases during pregnancy in our study.The prevalence of
Hypertensive disorders in pregnancy in our study was 7.7 %. In our study, We had one stillbirth baby, 36 neonates (7.8%)
requiring ICU support either incubator or mechanical ventilator for
prematurity, respiratory distress , 29 survived to discharge while 7
died. It was expected to find too many cases of rheumatic heart
diseases in pregnant females in menoufyia governorate, but in the
current study the prevalence of native and prosthetic heart disease was
.9% and .1% respectively similar to another study found that the
incidence of rheumatic heart diseases in the 5 years period study at 2
hospitals in San Luis and Mexico was .7% . We have been surprised in the current study by the huge
numbers of hypertensive heart diseases in pregnant women especially
numbers of pre eclampsia 304 cases which are quite similar to the
numbers in the western world. Women who develop hypertensive disorders in pregnancy
require education about their life time risks of cardiovascular disease,
and this opportunity should be taken to reduce cardiovascular risk
factors, such as diet and body mass index. Women who have had a
hypertensive disorder of pregnancy require long-term follow-up of
their cardiovascular risk factors, to reduce their risk of future
cardiovascular disease.