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Rheumatic heart disease in pregnancy: Strategies and lessons learnt implementing a population-based study in Australia
journal contributionposted on 2021-04-14, 01:58 authored by Geraldine VaughanGeraldine Vaughan, Kylie Tune, Michael J Peek, Lisa Jackson Pulver, Bo Remenyi, Suzanne Belton, Elizabeth A Sullivan
Background The global burden of rheumatic heart disease (RHD) is two-to-four times higher in women, with escalated risk in pregnancy. In Australia, RHD is found predominantly among Aboriginal and Torres Strait Islander peoples. Methods This paper reviews processes developed to identify pregnant Australian women with RHD during a two-year population-based study using the Australasian Maternity Outcomes Surveillance System (AMOSS). It evaluates strategies developed to enhance reporting and discusses implications for patient care and public health. Results AMOSS maternity coordinators across 262 Australian sites reported cases. An extended network across cardiac, Aboriginal and primary health care strengthened surveillance and awareness. The network notified 495 potential cases, of which 192 were confirmed. Seventy-eight percent were Aboriginal and/or Torres Strait Islander women, with a prevalence of 22 per 1,000 in the Northern Territory. Discussion Effective surveillance was challenged by a lack of diagnostic certainty; incompatible health information systems and varying clinical awareness among health professionals. Optimal outcomes for pregnant women with RHD demand timely diagnosis and access to collaborative care. Conclusion The strategies employed by our study highlight gaps in reporting processes and the opportunity pregnancy provides for diagnosis and re/engagement with health services to support better continuity of care and promote improved outcomes.
Category 1 - Australian Competitive Grants (this includes ARC, NHMRC)
Number of Pages10
PublisherOxford University Press (OUP)
Cultural WarningThis research output may contain the names and images of Aboriginal and Torres Strait Islander people now deceased. We apologize for any distress that may occur.
External Author AffiliationsMenzies School of Health Research, Darwin; Western Sydney University; University of Technology Sydney
Health information systemsHealth servicesIndigenous healthPregnancyPublic healthRheumatic heart diseaseAdultAustraliaFemaleHumansOceanic Ancestry GroupPregnancy Complications, CardiovascularPregnant WomenPublic Health SurveillanceCardiology (incl. Cardiovascular Diseases)Obstetrics and GynaecologyAboriginal and Torres Strait Islander Health