Heart disease, pulmonary tuberculosis and venereal diseases in pregnancy

Abstract

Although both the incidence (now below 1 % of all cases) and nature of heart disease in pregnancy has altered over the past 30 years, the condition remains one of considerable importance and is a major cause of maternal death in most countries of the western world. Rheumatic heart disease which accounted for over 90% of all cases seen before 1950 has declined in both incidence and severity in both the United Kingdom and the United States, and now congenital heart lesions account for approximately 30% of the total. The reasons for these changes include:

• (1) The discovery and use of antibiotics in the early 1940s; penicillin played a major role in reducing and controlling the incidence of streptococcal infections which precede rheumatic fever.

• (2) The improved social conditions which diminish the spread of infection.

• (3) The survival of more patients with congenital heart disease, many of whom have been cured by surgery and have become pregnant.