KwaZulu-Natal Department of Health; Department of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
S Afr Med J. 2022 May 31;112(6):403-404.
Cardiac disease is one of the commonest causes of indirect maternal deaths globally. This brief report is a reminder that isolated maternal tachycardia at rest is a clinical alert and warrants a detailed history in relation to cardiac disorders, thorough clinical examination of all organ systems, relevant investigations such as imaging, and expert advice to avoid serious adverse events. We reflect on a belatedly investigated persistent maternal tachycardia resulting in a fatal postpartum collapse due to mitral stenosis. The lost window of opportunity for appropriate investigation and management of the tachycardia provides an insight into many similar maternal deaths in South Africa. Key clinical messages regarding persistent maternal tachycardia are presented for midwives and doctors caring for pregnant women.
心脏病是全球间接产妇死亡的最常见原因之一。本简要报告旨在提醒大家,孤立的静息性母体心动过速是一个临床警示,需要详细了解与心脏疾病相关的病史、对所有器官系统进行彻底的临床检查、进行相关的影像学等检查,并寻求专家建议以避免严重不良事件。我们反思了一例因二尖瓣狭窄导致产后迟发性心动过速性心力衰竭的病例,该病例提示我们,许多南非的产妇死亡本可通过及时的检查和管理得到避免。本病例为助产士和妇产科医生提供了有关持续性母体心动过速的关键临床信息。