{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:49:07Z","timestamp":1784162947953,"version":"3.55.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Women with rheumatic heart disease (RHD) can have a lower cardiac reserve to cope with pregnancy and labour, leading to increased obstetric and cardiac risks. The Northern Territory has been repeatedly reported to have the highest prevalence of RHD in Australia, yet evidence specific to pregnancy is scarce in the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The primary aim of this paper is to describe the baseline characteristics and maternal outcomes of pregnant women with RHD presenting to the largest obstetrics referral hospital in the Northern Territory. The secondary aim is to evaluate the current model of care in relation to their cardiac status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational study was conducted over a 9.5\u2010year period. Demographics, cardiac, obstetrics and anaesthetics data were collected for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and twenty\u2010nine pregnancies were included for analysis. All women were identified as Aboriginal or Torres Strait Islander, and 85% were of a RHD priority of 2 or 3. Of all 28 patients who had an emergency caesarean section, only one patient was indicated for cardiac reasons. There was no maternal or neonatal death reported. Three preterm births were induced secondary to maternal concerns related to RHD cardiac decompensation. There were no major adverse neonatal outcomes, including neonatal death, intraventricular haemorrhage or respiratory distress syndrome. Multidisciplinary care was also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We observed a low rate of maternal and fetal morbidity and no mortality in a cohort of women with mild to severe RHD. These favourable outcomes have occurred in a multidisciplinary centre with significant experience in managing the medical and cultural complexities of this group.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13559","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T08:15:23Z","timestamp":1656404123000},"page":"74-80","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Rheumatic heart disease in pregnancy: Maternal and neonatal outcomes in the Top End of Australia"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1041-0551","authenticated-orcid":false,"given":"Chor Kiu (Maree)","family":"Lam","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3590-2907","authenticated-orcid":false,"given":"Jane","family":"Thorn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1240-1579","authenticated-orcid":false,"given":"Xylyss","family":"Lyon","sequence":"additional","affiliation":[{"name":"Department of Health  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8685-5389","authenticated-orcid":false,"given":"Edith","family":"Waugh","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6967-4175","authenticated-orcid":false,"given":"Ben","family":"Piper","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8301-9249","authenticated-orcid":false,"given":"Edwina","family":"Wing\u2010Lun","sequence":"additional","affiliation":[{"name":"Department of Cardiology Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Australian Institute of Health and Welfare.Acute Rheumatic Fever and Rheumatic Heart Disease in Australia: 2013\u20132017. Cardiovascular Disease Series Number 36 Catalogue no CVD 86. Canberra AIHW 2019."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.68.12.540"},{"key":"e_1_2_6_4_1","unstructured":"RHD Australia (ARF\/RHD writing group).The 2020 Australian guideline for prevention diagnosis and management of acute rheumatic fever and rheumatic heart disease (3rdedition);2020[cited 2021 Dec 23]. Available from URL:https:\/\/www.rhdaustralia.org.au\/arf\u2010rhd\u2010guideline"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy340"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15938"},{"issue":"19","key":"e_1_2_6_7_1","first-page":"e016851","article-title":"Contemporary incidence and prevalence of rheumatic fever and rheumatic heart disease in Australia using linked data: The case for policy change","volume":"9","author":"Katzenellenbogen JM","year":"2020","journal-title":"JAMA"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERP-17-0071"},{"key":"e_1_2_6_9_1","unstructured":"National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand (Chronic Heart Failure Guidelines Expert Writing Panel).Guidelines for the prevention detection and management of chronic heart failure in Australia. October2011."},{"key":"e_1_2_6_10_1","unstructured":"Australian Institute of Health and Welfare.Acute Rheumatic Fever and Rheumatic Heart Disease: in brief. AIHW;2019."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.033465"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1258\/om.2008.080002"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2021.10.017"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13102"},{"issue":"3","key":"e_1_2_6_15_1","first-page":"CD007412","article-title":"Active versus expectant management for women in the third stage of labour","volume":"2","author":"Begley C","year":"2015","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13559","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13559","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13559","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T15:44:18Z","timestamp":1692287058000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,28]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1111\/ajo.13559"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13559","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,28]]},"assertion":[{"value":"2021-12-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}