Disease spectrum and short-term outcomes of obstetric patients with cardiac disease admitted to an obstetric critical care unit in South Africa

\r\nBackground\r\nCardiac disease in pregnancy is a leading, indirect cause of maternal mortality. The disease spectrum differs between high-, middle-, and low-income countries. We describe the disease spectrum and short-term in-hospital outcomes in obstetric patients with cardiac disease at an obstetric critical care unit (OCCU) in an upper middle-income country (UMIC).\r\n\r\nMethods\r\nA single-centre, descriptive, historical cohort study was performed of all the obstetric patients with cardiac disease admitted between January 2018 and December 2019 to the Tygerberg Hospital (TBH) OCCU (n = 86) in Cape Town, South Africa (SA). We analysed groups according to the Cardiac Disease in Pregnancy (CARPREG) II and modified World Health Organization (mWHO) risk assessment tools.\r\n\r\nResults\r\nThree main groups were identified: valvular heart diseases (50%), cardiomyopathy (22%), and congenital heart disease (21%). The majority (88%) of 34 adverse cardiac outcomes occurred with cardiomyopathy and valvular disease. CARPREG II echocardiography high-risk parameters depended on the cardiac class: cardiomyopathy and valvular disease had a higher association (p