Management of Women with Rheumatic Heart Diseases during Pregnancy, Labour and Purperium

There is wide regional variation (0.3-3.5%) in incidence of maternal heart disease during pregnancy with a global figure of around 1%.Heart disease in pregnant women is most commonly due to rheumatic heart disease, congenital abnormalities and less commonly due to ischemic heart disease.In developing countries, rheumatic heart disease is still predominant and continues to be a major cause of maternal mortality.The likelihood of an adverse maternal and fetal outcome is related to the type and severity of maternal valvular disease and the resulting abnormalities of functional capacity.In Egypt, heart disease is the most common indirect cause of maternal mortality.Rheumatic mitral stenosis is the most common valvular abnormality encountered in pregnant women and may be associated with pulmonary edema, and atrial arrhythmias during pregnancy or soon after delivery. Mortality among pregnant women with minimal symptoms is less than 1%.The aim of this work is to highlight some recent lines for management of women with rheumatic heart diseases and their complications during pregnancy, labour and perpurium.