Rheumatic heart disease occurs when damage to one or more heart valves after one or more episodes of acute rheumatic fever. It is accounts for 1.5% of deaths in Thai population. Rheumatic fever can occur after an infection of the throat with a bacterium called group A streptococcus. The infection is common in children and the damage to heart valves might not show any symptoms for many years. Diagnosis may not occur until the time of pregnancy. The added stress on the heart can result in symptomatic rheumatic heart disease where previously there were no symptoms.
An example case is a 21 year old pregnant woman from Nauru. She was referred to Bangkok hospital due to rheumatic heart disease during her pregnancy. She thought that she might not be able to keep the baby. However, after consultations with a team consisting of an obstetrician, a cardiologist, and a pediatrician, the doctors agreed that termination of pregnancy is not required. With careful planning, monitoring, and support, she was able to continue with the pregnancy and a healthy baby was born. After the delivery, the mother had a heart valve surgery and was fully recovered.
Therefore, women suffering from rheumatic heart disease are able to conceive with careful preconception planning and care. The outcome of pregnancy can improve both for the mother and the baby through careful monitoring and support during pregnancy.
What is rheumatic heart disease?
Rheumatic heart disease is chronic damage to the valves of the heart, caused by episodes of acute rheumatic fever. Rheumatic fever usually occurs in children aged 5-15 while rheumatic heart disease is most commonly seen in adolescents and young adults. Rheumatic heart disease is a burden in developing countries and underprivileged communities.