Conclusion
This four-year audit of cardiac disease in pregnancy at a tertiary
referral centre reveals a high rate of morbidity, with 23 patients
(27%) having poor pregnancy outcomes. Monitoring of anticoagulant
therapy in patients with metallic valve prosthesis following
valve replacement needs to be improved to minimise foetal
loss and maternal bleeding problems most often encountered in
these patients. In addition, there was a significant misdiagnosis
rate. Echo-Doppler evaluation by echocardiography accurately
diagnosed the nature and severity of cardiac lesions, and so the
initial diagnosis was changed in seven patients, emphasising
the need for early referral for specialist care in cardiac cases as
recommended by the Saving Mothers Report.4