RHD in pregnancy – Echo screening introduced to address disease – Malo

Cure Kids Fiji RHD project manager Dr llikena Malo. Picture: FACEBOOK

The burden of rheumatic heart disease in pregnant women is not well defined as there has not been any research conducted to establish its prevalence in Fiji.

Cure Kids Fiji RHD project manager Dr llikena Malo said to address this they began a pilot research in August by introducing echo screening for pregnant mothers.

“Right now, our standard practice is that all women that come in for booking for antenatal care have doctors listen to their hearts to screen for RHD.

“The scan is more sensitive and is able to pick up RHD more accurately so that not a lot of cases are missed.

“There are some cases that were undiagnosed previously which have now been diagnosed.

“These were missed out during their childhood and while growing up which are now being picked up.”

He said RHD in pregnancy could bring complications that could lead to death.

“There have been a few cases in the past where a mother has been pregnant, turned up to the hospital, collapsed and only to be found to have RHD.

“Pregnancy itself in someone with RHD can worsen the clinical stage from mild to severe stage and it also depends on the stage of pregnancy and the number of pregnancies that they’ve had prior to when they were detected.

“The earlier it is detected during antenatal, the quicker we can come up with a management plan so that at the end there is a safe delivery with a healthy mother and baby.”

He said from the pilot and feasibility study, the program will be able to make recommendations to the ministry in rolling this throughout antenatal clinics in the future.

“We’re going to make recommendations to the Ministry of Health as from our findings whether or not we are able to roll this out.

“So right now it’s just CWM (Hospital), Lami health centre, Makoi health centre and Raiwaqa health centre.

“The plan is to carry this out for six months and then we’ll review whether we have enough numbers to clearly say that how much of a burden RHD poses on our pregnant women population.”

He said conventionally the echo would be carried out by specialists, a paediatrician or a cardiologist, however for the study health care workers such as obstetric doctors and midwives were being trained.

“We teach them for a brief period of four weeks on how to use the echo machine and how to diagnose RHD.”

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