Intern Med J. 2012 Sep;42(9):978-84. doi: 10.1111/j.1445-5994.2012.02725.x.
Rheumatic heart disease (RHD) remains an important health issue for indigenous women of child-bearing age in northern Australia. However, the influence of RHD on maternal outcomes with current clinical practice is unclear.
To determine maternal cardiac complications and obstetric outcomes in patients with RHD.
Retrospective case note analysis of women with RHD who received obstetric care between July 1999 and May 2010 at Cairns Base Hospital in north Queensland. Outcome measures were obstetric interventions and outcomes, cardiac interventions and complications, stratified according to a cardiac risk score (CRS).
Ninety-five confinements occurred in 54 patients, of whom 52 were Indigenous Australians. There were no maternal or neonatal deaths. With a CRS of 0, cardiac complications occurred in 0 of 70 confinements; with a CRS of 1, complications occurred in 5 of 17 confinements (29%); with a CRS of >1, complications occurred in 2 of 4 confinements (50%). Another four patients were first diagnosed with RHD after developing acute pulmonary oedema during the peripartum period.
RHD has a major impact on maternal cardiac outcomes. However, with current management practices, maternal and fetal mortality are low, and the incidence of complications is predictable based on known risk factors.
风湿性心脏病（RHD）仍然是澳大利亚北部育龄期土著妇女的一个重要健康问题。然而，目前临床实践中 RHD 对产妇结局的影响尚不清楚。
确定患有 RHD 的产妇的心脏并发症和产科结局。
对 1999 年 7 月至 2010 年 5 月在昆士兰北部凯恩斯基地医院接受产科护理的 RHD 妇女的病历进行回顾性分析。结局指标为产科干预和结局，根据心脏风险评分（CRS）分层的心脏干预和并发症。
在 54 名患者中，有 95 次分娩，其中 52 名是土著澳大利亚人。没有产妇或新生儿死亡。CRS 为 0 时，70 次分娩中无心脏并发症；CRS 为 1 时，17 次分娩中有 5 次（29%）出现并发症；CRS>1 时，4 次分娩中有 2 次（50%）出现并发症。另有 4 名患者在围产期发生急性肺水肿后首次被诊断为 RHD。
RHD 对产妇心脏结局有重大影响。然而，根据目前的管理实践，母婴死亡率低，并发症的发生率可根据已知的危险因素进行预测。
