Heart Disease, Parturition and Antibiotic Prophylaxis

The relative incidence of congenital and rheumatic heart disease in obstetric practice is changing. Hamilton (1947) recorded chronic rheumatic heart disease in 93% of 1335 pregnant cardiac patients; miscellaneous cardiovascular diseases, including syphilis, occurred in 1.8%, and 5.2% had congenital cardiovascular defects. The ratio of 1:20 for congenital and rheumatic heart disease was also observed by Szekely and Snaith (1974), during the 10-year period between 1942 and 1951, but changed to 1:3 in the decade 1962–1971. The decrease of rheumatic heart disease in the community is reflected in obstetric practice (Hurley, 1972) and early palliative and corrective surgery results in an absolute increase in the number of women with congenital heart disease who reach childbearing age.