{"paper_id":"00a27da7-da9f-4946-843b-25b3321fc318","body_text":"Prevalence of Cardiovascular Diseases among Pregnant Women Attending Antenatal Care in Jimma University Medical Center, Southwest Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence of Cardiovascular Diseases among Pregnant Women Attending Antenatal Care in Jimma University Medical Center, Southwest Ethiopia Temare Birhanu, Tadesse Dukesa, Elsah Tegene, Teshome Kabeta, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1639429/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Pregnant women with underlying cardiovascular diseases (CVDs) are at increased risk for adverse maternal and perinatal outcomes due to difficulty in tolerating the physiologic changes of pregnancy. Maternal CVDs are responsible for 10-15% of maternal death. Rheumatic heart disease is the commonest cardiac disease among pregnant women in developing countries. Despite all this, there is no adequate data on the overall prevalence of cardiovascular diseases among pregnant women in our setup as well as in Ethiopia. Objectives The aim of the study was to assess the prevalence of cardiovascular diseases among pregnant women who had antenatal care follow up at Jimma University Medical center from October 2021 to December 2021. Methods An institution based cross sectional study was conducted among pregnant women who had antenatal care follow up at Jimma University Medical Centre. We used systematic random sampling to get sample population. Data were collected by using structured questionnaire; sphygmomanometer, echocardiogram, and electrocardiogram. The data were then entered to Epi data and exported to SPSS Version 26 for statistical analysis. Descriptive data summarizations and presentations were done to find the prevalence of CVDs in the study population. Result A total of 156 pregnant women were enrolled in this study. The overall prevalence of cardiovascular disease was 16.7%; of which 10.3% had hypertensive disorders of pregnancy and 6.4% had cardiac disease. Preeclampsia accounted for 6.4% followed by gestational hypertension (2.6%) and chronic hypertension (1.3%).Chronic rheumatic heart disease accounted for 3.2%.atrial septal aneurysm (1.9%) and hypertensive heart disease (1.3%). In those with rheumatic heart disease, mitral valve lesions were the prominent. T wave abnormalities were the most common electrocardiography finding. Most, 121(22.4%), of the study participants had at least one abnormal echocardiography finding and among them 64(41%) had abnormal valvular lesions. Among those with valvular lesions, 5 (3.2%) had chronic rheumatic heart disease whereas 59(37.8%) had physiologic valvular lesions. Conclusion The prevalence of cardiovascular diseases among third trimester pregnant women was high in our setup. So screening all pregnant women with electrocardiography and echocardiography is important. Cardiac & Cardiovascular Systems Cardiovascular diseases pregnancy electrocardiography echocardiography Ethiopia Figures Figure 1 Background Cardiovascular diseases (CVDs) are the leading cause of death globally. An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke. Over three quarters of CVD deaths take place in low- and middle-income countries. Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2019, 38% were caused by CVDs ( 1 – 2 ). In the similar manner, CVDs are the leading causes of non-obstetric maternal death during pregnancy ( 2 ). Maternal CVDS complicate between 1 and 4% of all pregnancy and responsible for 10–15% of maternal death. Nowadays, it has become the leading cause of maternal death globally ( 3 – 5 ). The pregnant women are in a marked hyper-dynamic and volume-overloaded state as a result of physiological changes during pregnancy. Cardiac output increases by 30–50% during pregnancy and further increases during labor and delivery ( 6 ).Women with underlying heart disease cannot tolerate these additional hemodynamic burden of pregnancy which may exaggerate the underlying disease, resulting in increased morbidity and mortality to the mother, fetus or both ( 3 ). Heart disease in pregnancy represents a spectrum of etiologies including; cardiomyopathies, valvular heart disease (VHD), pulmonary hypertension, and adult congenital heart disease ( 7 ) and also ischemic heart disease and cardiac arrhythmias( 8 ). Of these, rheumatic heart disease (RHD) is the most common in developing countries, mitral stenosis (MS) being the predominant lesion among all presentations, whereas cardiomyopathies and congenital heart disease are more common in developed countries ( 9 ). A study done in Saint Paul’s Hospital Millennium Medical College revealed that 10.3% of pregnant mothers had cardiovascular disease and a relatively high proportion of rheumatic heart disease was seen among the pregnant mothers ( 2 ). About 8.3% of the mothers have at least one echocardiographic abnormality out of which 2.3% had significant rheumatic heart disease and 1.0% of the mothers have moderate-severe pulmonary hypertension. In another echocardiographic study done in Eritrea, about 2.3% of the pregnant women showed subclinical RHD 95% CI (0.7–3.9) ( 10 ). A study done by Moges Beriye et al showed that the prevalence of VHD in pregnant women was 0.6%. Out of a total of 29 pregnant women 28 (96.6%) had rheumatic heart disease. MS (75.9%) was the most frequent mitral valve pathology and 16 (55.2%) had severe MS ( 11 ) Likewise, a systematic review and meta-analysis done in Ethiopia in 2020 showed the pooled prevalence of hypertensive disorder of pregnancy to be 6.82% -( 12 ). Despite all these, only few published findings are available concerning CVDs during pregnancy in Ethiopia and the national policy of Ethiopia does not give adequate emphasis on the burden of CVDs in pregnancy. Thus, this study is aimed at showing and filling this gap by assessing the burdens of cardiovascular diseases among pregnant women in Jimma University Medical Centre (JUMC). Hence, the findings of the study will be input for reviewing health policies at regional and national level. Materials And Methods Study Area, Design and Period The study was conducted in JUMC. JUMC is a tertiary comprehensive hospital located in Jimma town, Southwest Ethiopia. The hospital has a catchment population of 20 million people. The study design was institution based cross-sectional study. The study commenced from October 2021 to December 2021. Study population We recruited pregnant women who were in the 3 rd trimester of pregnancy who were in antenatal care follow up at JUMC during the study period. We used systematic random sampling technique to select the study populations. Inclusion and Exclusion criteria All women with confirmed 3rd trimester pregnancy and willing to participate in the study were included in the study. But, non-pregnant women who came for preconception counseling; those who were in the first and second trimester pregnancy; and those who were in 3 rd trimester pregnancy but were not willing to give their written consent were excluded from the study. Sample Size determination and sampling technique Sample size was calculated using single population formula. The formula and calculation procedure is indicated below: , Where n is sample size, Z is standard normal distribution value at 95% confidence level of α/2= 1.96, P is 10.3% ( Is taken from the prevalence of cardiovascular diseases in St. Paul’s Hospital Millennium Medical College (2) , and d = margin of error= 5%. Accordingly, the sample size is calculated as: n = (1.96)2 0.103(1-0.103)/0.0025= 141.97=142. We then added 10% non-response rate and got a sample size 156. Hence, we conducted the study on 156 third trimester pregnant women. Data Collection procedure Data were collected using structured questionnaire written in English and was translated to the local language the study participant can understand/speak. Data were collected on socio-demographic characteristics (age, education level, occupation, marital status, place of residence, income of the family, religion and ethnicity);and medical, obstetrics and gynecologic factors (hypertension, diabetes, kidney disease, Smoking, gravidity and parity, gestational age, number of living children, contraceptive use and type before the index pregnancy, functional status, previous history of admission and/or treatment due to cardiovascular disease, type of cardiovascular disease, and family history of chronic illnesses). We used four medical doctors to collect questionnaire data and supervision was done by the principal investigator. The data collectors and supervisor applied COVID-19 precaution rules (Sanitizing hand, wearing gloves and face masks) and the study subjects also used followed the precaution rules. Social distance kept as much as possible Blood pressure, echocardiography and electrocardiography assessment Blood pressure was measured at both arms and the higher was taken. Clinical echocardiography screening was done using My alpha lab (ESAOTE S.p.A ,SN; 50384) and Samsung machines and electrocardiography was done using electrocardiogram machine SE-1200 Express model. These measurements were done after the women took 30 minutes rest. Urinalysis, renal function tests, liver enzymes and complete blood count were done for those who were hypertensive. Data quality control Quality of data was maintained by one day training of the data collectors. Pretesting of the questionnaire as a pilot was undertaken before the actual data collection. All filled questionnaires were checked for completeness and cleaned manually before the analysis by the principal investigator. Data processing and analysis The questioners was coded and entered into Epidata version 3.1statistical software and then exported into Statistical Package for Social Science (SPSS) version 26 for further analysis. Data was summarized and presented using descriptive statistics. Logistic regression was computed to assess statistical association, and significance of statistical association was considered to be significant if P-value ≤ 0.5. Result Socio-demographic characteristics of study participants The mean age of the study participants was 25.97(±4.6), with a minimum of 18 and maximum of 37 years. Majority of the participant pregnant mothers were from the Oromo ethnic group 96 (61.5%) followed by the Amhara ethnic group (16.7%) and Dawuro (6.4%).The Majority of them were Muslim by religion (54.5%) followed by Orthodox Tewahdo Christian (28.2%) and Protestant (16%). The educational status of the majority of the participants were elementary school (32.1%) followed by higher education (28.8%) and secondary school (28.2). The occupational status of majority of the participants were housewife (61.5%) and, monthly income of majority of them was not adequate (48.7%).Majority of them were married (99.4%).Most of the study participants were from Jimma Zone, mostly from Jimma town. Socio-demographic data is summarized in table 1. Obstetric characteristics of the study participant Majority of study participants had 4 ANC visits and about 60% were two to four gravidity and one to four parity. Concerning contraception uses, about three-fourth were on contraception methods before the index pregnancy and depo Provera was the most frequently used. The pregnancy was planned in most of them (Please see table 2). Medical History of the study participants Nine (5.8%) of the study participants had previous admission; of whom three of them were admitted because of cardiovascular disease and six of them were admitted for other than cardiovascular diseases. Five (3.2%) of the study participants were diagnosed to have cardiovascular diseases before the index pregnancy of whom two (1.3%) were hypertensive and three (1.9%) were known to have cardiac disease. Eight (5.1%) of the study participants had known co-morbid chronic illness other than cardiovascular disease and thirty-three (21.25%) had family history of chronic illness among whom majority had family history of hypertension 26(16.7%). Among the study participants, 27(17.3%) had dyspnea and most of them were in NYHA class I. The frequency and percent of orthopnea, PND and palpitation were 5(3.2%), 4(2.6%) and 20(12.8%) respectively. The detail of medical history of the women is indicated in supplementary table 1. Physical Examination Findings of the study participants The mean pulse rate of the study participants was 91.62(±10.9). The mean systolic blood pressure was 115.54mmHg (±13.7); the minimum was 90 mmHg and the maximum was 162mmHg. The mean diastolic BP was 74.69mmHg (SD = 10); the minimum was 60mmHg and the maximum was 110mmHg.The mean respiratory rate was 20.72(SD =1.6) with minimum of 20 and maximum of 36.The temperature and oxygen saturation were within normal range for all of the study participants. From the study participants, 16(10.3%) had hypertensive disorders of pregnancy. Please see table 3. During physical examination of the study participants; two (1.3%) had pale conjunctiva, two (1.3%) had enlarged thyroid gland, one (0.6%) had displaced PMI, nine (5.8%) had murmurs from whom PR and MR were the frequent findings and fifteen (9.6%) had leg edema. ECHOCARDIOGRAPHY FINDINGS OF THE SUDY PARTICIPANTS Echocardiography findings are summarized in table 4. Most, 121(22.4%), of the study participants had at least one abnormal echocardiography finding and among them 64(41%) had abnormal valvular lesions. Among those with valvular lesions, 5 (3.2%) had chronic rheumatic heart disease whereas 59(37.8%) had physiologic valvular lesions. Four (2.6%) study participants had anemia. One study participant had abnormal liver enzyme, AST, and the value was 67(1.8x elevated).The other liver enzymes were within normal range. Five (3.2%) of the study participants had proteinuria. Among hypertensive disorders of pregnancy, preeclampsia was the predominant finding of which preeclampsia with severity features accounted for 37%. Among those with CRHD, 3.2% were in NYHA class 1 dyspnea, 0.6 % had orthopnea and 1.3% had palpitation. Electrocardiogram Findings of the Study Participants Table 5 summarized ECG findings of the study participants. Accordingly, most of the study participants, 132(84.6%), had at least one ECG abnormality from whom thirty four (21.8%) had sinus tachycardia; two (1.3%) had sinus bradycardia; six (3.8%) had premature ventricular beats and nine (5.8%) had left axis deviation. The result of ECG investigation also indicated that nine (5.8%) of the pregnant mothers had counterclockwise rotation of transition zone, four (2.6%) had left anterior hemi-block, one (0.6%) had LVH and one (0.6%) had short PR interval. T wave changes occurred in 103(66%) of the study participants whereas T wave inversion occurred in 83(53.2%) and most of the inversion occurred in V1, 75(48.1%), followed by lead III, 37(23.5%), and V2, 21 (13.5%). Flattening of T wave occurred in 47(30.1%) where most of the flattening occurred in lead III (21.2%). On the contrary, Q wave occurred in 26(14.7%) of the study participants which was mostly in lead III, 18(11.5%), and aVL, 5(3.2%). Low voltage of the ECG was seen in 16(10.2%) of the study participants mostly in aVF, aVL and lead III. Overall prevalence of cardiovascular diseases The prevalence of CVDs in our study population is 16. 7. HDP was found in 10.3%; RHD was found in 3.2%; atrial septal aneurem was found in 1.0% and HHD was found is 1.3% (figure 1). Discussion From the result of this study, the prevalence of cardiovascular diseases among pregnant mothers attending ANC at JUMC was 16.7%. HDP and CRHD were the predominant findings. Of which HDP accounted for 10.3%, CRHD accounted for 3.2%, atrial septal aneurysm accounted for 1.9% and HHD accounted for 1.3%. Summing up all cardiac conditions together, the prevalence of cardiac disease was 6.4%. The overall prevalence of cardiovascular diseases was higher because of the increased prevalence of hypertensive disorders of pregnancy. In addition, one of the study participants had both HDP and CRHD and, two of the study participants had both HDP and HHD. HDP was the predominant finding in this study which occurred in 16(10.3%) of the study participants; of which preeclampsia accounted for 6.4% followed by gestational hypertension which accounted for 2.6% of cases. This findings was higher than the previous study done a decade ago in Jimma University specialized Hospital, in which the overall prevalence of HDP were 8.5% from which severe preeclampsia was the predominant finding (51.9%) ( 13 ).The same was true in this study also, preeclampsia was the predominant finding which accounted for 62% of cases. The prevalence of preeclampsia in this study was lower than that of the studies done in Dessie referral hospital (8.4%) ( 14 )and Mettu Karl referal hospital (12.4%) ( 15 ). The prevalence of HDP in this study was also higher than a study done in St. Paul’s Hospital Millennium medical college in which the prevalence of HDP was 6.5% ( 2 ). But, it was lower than a study done among pregnant women attending ante natal care at Gondar town health Institutions, North West Ethiopia 2017, in which the prevalence of hypertensive disorders of pregnancy was 16.8% ( 16 ). CRHD was the second predominant finding in this study, as it is the common finding in developing countries, occurred in 5(3.2%) of the study participants which was nearly similar to the study conducted in 2017 which reported that prevalence of definite RHD in rural Ethiopia to be 3.7% on population based echocardiographic study in Jimma Zone, South West Ethiopia ( 17 ). In this study, 5(3.2%) of the study participants had MR (4 moderate and 1 severe), 2(1.3%) of them had MS (1 moderate and 1 severe), 2 (1.3%)of them had TR (1 mild and 1 severe) and 2(1.3%) of them had mild AR. Two patients had moderate pulmonary hypertension. Mitral valve lesions were the commonest findings, from which MR was the predominant finding in contrary to other studies in which MS was the most common rheumatic valvular lesion encountered during pregnancy ( 11 , 18 ). This finding is similar to other studies done in India and Sudan ( 9 , 19 ) in which rheumatic heart disease was the predominant cardiac finding in pregnant mothers. But the prevalence of RHD in this study was higher than the study done in St. Paul’s Hospital ,Ethiopia and, Eritrea which showed to be (2.3%) ( 2 , 10 ). In this study the mean age was 25.8 and the range was 23–30 which is similar to age range of RHD. Since RHD is the disease of poverty, all of the cases with RHD had no enough income. Among them, 60% had no adequate income and 40% had no income at all. The 3rd predominant finding in this study was atrial septal aneurysm which occurred in 3(1.9%) of the study participants. This finding was lower than that of the study done in Turkey in which the prevalence of atrial septal aneurysm was 5.67% ( 20 ) . The other major finding in this study was HHD which occurred in 2 (1.3%) of the study participants. Both of those study participants had moderate LVH and grade 1 diastolic dysfunction. This could be due to undiagnosed chronic hypertension with superimposed preeclampsia. When we see the echocardiography findings, most of them had benign findings; 92(59%) of the study participants had mild pericardial effusion. This is thought to be related to hormone mediated volume retention mostly during the 3rd trimester pregnancy. This result was higher than other studies in which the prevalence of pericardial effusion in 3rd trimester pregnancy was 40% ( 21 ).Moreover, our study found mild regurgitation 59(37.8%), mostly from the pulmonic valve, which is due to the physiologic change in pregnancy. This finding is similar with Afari HA et al which found valvular regurgitation in tricuspid and pulmonic valves ( 21 ).The prevalence of LVH in this study was 3.8% which is less than other study in which the prevalence was 5–10% ( 21 ). In this study, 3(1.9%) of the study participants with moderate LVH had hypertensive disorders of pregnancy and 3 (1.9%) of the study participants with mild LVH had normal blood pressure. Blood pressure and LVH had significant correlation at the 0.01 level (2 tailed), Pearson correlation. The ejection fractions of the study participants were within normal range. Most of the study participants, 132(84.6%), had at least one ECG abnormality. T wave changes occurred in 103(66%) of the study participants. T wave inversion occurred in 83(53.2%) and most of the inversions occurred in V1,75(48.1%) followed by lead III 37(23.5%) and V2 21 (13.5%).T wave flattening occurred in 47(30.1%) and most of the flattening occurred in lead III 33(21.2%) followed by aVF 15 (9.6%) and V1 10(6.4%).Peaked T wave occurred in 3(1.9%) of the study participants mostly fromV1 to V3.In the above description, the summation of T wave inversion with its components as well as T wave flattening is greater than the total T wave changes because one case may have more than one T wave abnormalities. This is similar to the study done in Nepal among 3rd trimester pregnant women which showed: - T wave inversion occurred mostly in V1 (88.3%), V2 (60%), lead III (43.3%) and T wave flattening occurred mostly in lead III (50%), V3 (30%) and aVF (13.3%) ( 22 ). This finding is also similar to another study which showed:-T wave inversion occurred mostly in V1 (84%), lead III (54%),V2 (20%) and T wave flattening occurred lead III (26%) and V1 (6%) ( 23 ). Sinus tachycardia occurred in 34(21.8%) of the study participants ;this is because heart rate increases progressively with pregnancy, reaching a peak during the 3rd trimester ( 22 , 24 , 25 , 26 ). Nine (5.8%) had left axis deviation which is similar to other studies ( 22 , 23 , 24 );among them 2 of them had hypertensive disorders of pregnancy and one of them had chronic rheumatic heart disease. One (0.6%) had short PR interval which is common in pregnancy due to physiologic changes and similar findings were seen also in another studies (22,24,25, 26 ( 22 , 24 , 25 , 26 ). Six (3.8%) of the study participants had premature ventricular beats which is due to physiologic changes of pregnancy but the result of this study was lower than other studies which showed premature beats to be 59%% ( 27 ).This could be due to the single ECG recording we used for our study as this can miss some PVCs. In this study Low voltage of the ECG was seen in 16(10.2%) of the study participants mostly in aVF, aVL, lead III which is similar finding to another study (30) .Nine (5.8%) pregnant mother had counterclockwise rotation of transition zone, 4 (2.6%) had left anterior hemi-block, 1(0.6%) had LVH and 2(1.3%) had sinus bradycardia. Twenty six (16.7%) of the study participants had Q wave in any lead ;mostly occurred in lead III which accounted for 11.5% followed by aVL which accounted for 3.2% and 1.3% in lead 1. Similar finding was seen in a study done in Nepal in which the increased number of Q waves appeared in 3rd trimester pregnancy highly statistically significant in lead III (35%), II(30%) and aVL (18.3%) and statistically significant in lead I(18.3%) ( 22 ). Another study also showed similar findings with significantly increased occurrence of prominent Q waves in lead III (40%), aVF (38%) and II (26%) in 2nd and 3rd trimester of normal pregnancy ( 23 ). Strength and Limitation of the study This is the 1 st prevalence study that included the ECG and echocardiography findings of 3 rd trimester pregnant mothers and also findings of atrial septal aneurysm. This is the strength of the study. Therefore, it can be used as a base line study and can give an entry point to other researchers for further wider studies in the area. However, it had its own limitation. First, the study was done in a single center with small sample size. Therefore, it is difficult to generalize to larger population. Second, the study lacked follow-up ECG and Echocardiography investigation to see changes of the abnormalities overtime. That limited us from knowing the outcome of the abnormalities. Conclusion Prevalence of cardiovascular diseases among 3rd trimester pregnant women attending ANC follow-up clinic at JUMC was 16.7% of which hypertensive disorders of pregnancy accounts for 10.3% and cardiac diseases accounts for 6.4% .From hypertensive disorders of pregnancy; preeclampsia was the commonest finding accounting for 6.4% followed by gestational hypertension (2.6%). From the cardiac diseases RHD was the predominant finding accounting 3.2% of cases followed by atrial septal aneurysm (1.9%) and HHD (1.3%). In the case of RHD, mitral valve involvement was the predominant finding and MR was the commonest one and 1.3% of them have moderate pulmonary hypertension. Most of the ECG findings showed T wave changes, mostly inversion followed by flattening. T wave inversions were commonly seen in V1 (48.5%) followed by lead III (23.5%) and V2 (13.5%). T wave flattening were seen commonly in lead III (21.2%) followed by aVF (9.6%). In the similar manner, the major echocardiography findings among the 3rd trimester pregnant women attending ANC follow-up clinic at JUMC were mild pericardial effusion and mild valvular regurgitation, commonly from pulmonary valve. Most ECG and ECHO findings are physiologic changes of pregnancy. So interpretation should be with consideration of these findings. Declarations Ethics approval and consent to participate The study was approved by Jimma University Institute of Health's Institutional Review Board. Written informed consent was taken from the study participants. Written informed consent was obtained from each participant and participant’s anonymity and confidentiality was kept. Consent for publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests Funding This research was funded by Jimma University. The funder had no role in the design of the study; data collection; data interpretation; and writing of the manuscript. Authors' contributions 1 has contributed to the study designs, clinical concepts, document writing and conceptualization, editing final documents, data analyses, and interpretation. 2 has contributed to the study designs, clinical concepts, document writing and conceptualization, editing final documents. 3 has contributed to the study designs, clinical concepts, document writing and conceptualization, editing final documents, data analyses, interpretation, preparing and reviewing the whole documents. He is the guarantor. 4 has contributed to the study designs, clinical concepts, document writing and conceptualization. 5 has contributed to preparing and reviewing the whole documents. Acknowledgement The authors thank all of the participants and data collectors for their contributions. Abbreviations ANC- antenatal care AR-Aortic regurgitation CVDs-Cardiovascular disease HD-Heart Disease HDP-Hypertensive disorders of pregnancy HHD-Hypertensive heart disease JUMC-Jimma University Medical Center MR-Mitral regurgitation MS-Mitral stenosis NYHA-New York heart association PH-Pulmonary hypertension PR-Pulmonary regurgitation PVCs- Premature ventricular beats RHD-Rheumatic Heart Disease TR-Tricuspid regurgitation VHD-Valvular Heart Disease References https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) Bacha D, Abera H, Adem A, Tadesse F, Bekele D. 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Available from: https://doi.org/10.1016/j.ccl.2020.09.013 Tables Table1: Socio-demographic characteristics of 3 rd trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022. Variable FREQEUNCY PERCENT Age ≤25 83 53.2 26_35 68 43.6 ≥36 5 3.2 Ethnicity Oromo 96 61.5 Amhara 26 16.7 Dawuro 10 6.4 Yem 7 4.5 Kaffa 7 4.5 Gurage 5 3.2 Other 5 3.2 Religion Muslim 85 54.5 Orthodox Tewahdo Christian 44 28.2 Protestant 25 16 Adventist 2 1.3 Educational Status No formal education 17 10.9 Elementary school 50 32.1 Secondary school 44 28.2 Higher education 45 28.8 Occupational Status Housewife 96 61.5 Merchant 4 2.6 Employee 45 28.8 Daily labourer 11 7.1 Monthly income Adequate 29 18.6 More than enough 1 0.6 Not adequate 76 48.7 No income 50 32.1 Marital Status Married 155 99.4 Widowed 1 0.6 Table2 Obstetric profile of 3 rd trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022. Variable Frequency Percent Gravidity 1 52 33.3 2-4 92 59 ≥5 12 7.7 Parity 0 62 39.7 1-4 93 59.6 ≥5 1 0.6 ANC visit Yes 156 100 No 0 0 No- of ANC visit 1 24 15.4 2 19 12.2 3 33 21.2 4 47 30.1 >4 33 21.2 Use of contraception method before Yes 118 75.6 No 38 24.4 Type of contraceptive Method OCP 19 12.2 Implanon 45 28.8 Depo provera 63 40.4 IUCD 4 2.6 Pregnancy Planned 132 84.6 Unplanned 24 15.4 Table 3 Physical examination findings of 3rd trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022. Variables Frequency Percent Pale conjunctiva 2 1.3 Enlarged thyroid gland 2 1.3 Displace PMI 1 0.6 Murmurs MR 4 2.6 MS 1 0.6 TR 1 0.6 PR 6 3.8 Edema Grade 1 9 5.8 Grade 2 6 3.8 Table 4: Echocardiography abnormalities of 3rd trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022 Variables Frequency Percent Echocardiography Abnormal 121 77.6 Valvular lesions 64 41.0 Mitral stenosis Moderate 1 0.6 Severe 1 0.6 Mitral regurgitation Mild 4 2.6 Moderate 4 2.6 Severe 1 0.6 Aortic regurgitation Mild 2 1.3 Tricuspid regurgitation Mild 8 5.1 Moderate 1 0.6 Pulmonic regurgitation mild 57 36.5 Causes of valvular lesions CRVHD 5 3.2 Physiologic 59 37.8 LVH Mild 3 1.9 Moderate 3 1.9 Diastolic dysfunction Grade 1 2 1.3 Hypertensive heart disease 2 1.3 Pulmonary hypertension Moderate 2 1.3 Pericardial effusion Mild 92 59 Atrial septal aneurysm 3 1.3 Table 5 General ECG abnormalities of 3rd trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022. Variables Frequency Percent Sinus tachycardia 34 21.8 Sinus bradycardia 2 1.3 Premature ventricular beats 6 3.8 Left axis deviation 9 5.8 Short PR interval 1 0.6 Counter clockwise rotation of transition zone 9 5.8 Left anterior hemi-block 4 2.6 LVH 1 0.6 Poor R wave progression 9 5.8 P wave Biphasic V1 and lead 2 2 1.3 Inverted lead 3 1 0.6 Peaked V1 2 1.3 T wave changes 103 66 Q wave changes 26 16.7 Low voltage 16 14.7 S1Q3T3 1 0.6 Supplementary Files Supplementaryfigure.docx Supplementarytables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-1639429\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":104714729,\"identity\":\"66b8359c-31dd-48c1-aac7-17bcd8b9de17\",\"order_by\":0,\"name\":\"Temare Birhanu\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"St Paul's Millennium Medical College\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Temare\",\"middleName\":\"\",\"lastName\":\"Birhanu\",\"suffix\":\"\"},{\"id\":104715496,\"identity\":\"8429db23-7542-479b-bcdd-84b8f51ca547\",\"order_by\":1,\"name\":\"Tadesse 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women who were attending ANC follow up clinic at JUMC, Southwest Ethiopia, 2022.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"ScreenShot20220510at2.03.33PM.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1639429/v1/0a8e6f6ee2ce2b649294fd30.png\"},{\"id\":21299739,\"identity\":\"e80fc90f-39fc-4c0a-a03e-b2d56b05e356\",\"added_by\":\"auto\",\"created_at\":\"2022-05-10 18:23:47\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":604406,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1639429/v1/8b2c3947-ba3c-4432-a0a1-7436f0c8ef71.pdf\"},{\"id\":21299684,\"identity\":\"9c8351e3-25d2-47e5-aa57-581c73618a82\",\"added_by\":\"auto\",\"created_at\":\"2022-05-10 18:18:44\",\"extension\":\"docx\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":12636,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Supplementaryfigure.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1639429/v1/b126c46388a59bc96c8b481f.docx\"},{\"id\":21299737,\"identity\":\"5acc5504-2923-4a1b-b7ca-a2ff5d4678a3\",\"added_by\":\"auto\",\"created_at\":\"2022-05-10 18:23:44\",\"extension\":\"docx\",\"order_by\":2,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":15654,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Supplementarytables.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1639429/v1/e0927dd349a415df9c9bdeea.docx\"}],\"financialInterests\":\"\",\"formattedTitle\":\"\\u003cp\\u003ePrevalence of Cardiovascular Diseases among Pregnant Women Attending Antenatal Care in Jimma University Medical Center, Southwest Ethiopia\\u003c/p\\u003e\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\",\"fulltext\":[{\"header\":\"Background\",\"content\":\"\\u003cp\\u003eCardiovascular diseases (CVDs) are the leading cause of death globally. An estimated 17.9\\u0026nbsp;million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke. Over three quarters of CVD deaths take place in low- and middle-income countries. Out of the 17\\u0026nbsp;million premature deaths (under the age of 70) due to noncommunicable diseases in 2019, 38% were caused by CVDs (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eIn the similar manner, CVDs are the leading causes of non-obstetric maternal death during pregnancy (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). Maternal CVDS complicate between 1 and 4% of all pregnancy and responsible for 10\\u0026ndash;15% of maternal death. Nowadays, it has become the leading cause of maternal death globally (\\u003cspan additionalcitationids=\\\"CR4\\\" citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e).\\u003cdiv class=\\\"BlockQuote\\\"\\u003e\\u003cp\\u003eThe pregnant women are in a marked hyper-dynamic and volume-overloaded state as a result of physiological changes during pregnancy. Cardiac output increases by 30\\u0026ndash;50% during pregnancy and further increases during labor and delivery (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e).Women with underlying heart disease cannot\\u003c/p\\u003e\\u003cp\\u003etolerate these additional hemodynamic burden of pregnancy which may exaggerate the underlying disease, resulting in increased morbidity and mortality to the mother, fetus or both (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003eHeart disease in pregnancy represents a spectrum of etiologies including; cardiomyopathies, valvular heart disease (VHD), pulmonary hypertension, and adult congenital heart disease (\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e) and also ischemic heart disease and cardiac arrhythmias(\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e). Of these, rheumatic heart disease (RHD) is the most common in developing countries, mitral stenosis (MS) being the predominant lesion among all presentations, whereas cardiomyopathies and congenital heart disease are more common in developed countries (\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e).\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/p\\u003e \\u003cp\\u003eA study done in Saint Paul\\u0026rsquo;s Hospital Millennium Medical College revealed that 10.3% of pregnant mothers had cardiovascular disease and a relatively high proportion of rheumatic heart disease was seen among the pregnant mothers (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). About 8.3% of the mothers have at least one echocardiographic abnormality out of which 2.3% had significant rheumatic heart disease and 1.0% of the mothers have moderate-severe pulmonary hypertension. In another echocardiographic study done in Eritrea, about 2.3% of the pregnant women showed subclinical RHD 95% CI (0.7\\u0026ndash;3.9) (\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eA study done by Moges Beriye et al showed that the prevalence of VHD in pregnant women was 0.6%. Out of a total of 29 pregnant women 28 (96.6%) had rheumatic heart disease. MS (75.9%) was the most frequent mitral valve pathology and 16 (55.2%) had severe MS (\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e) Likewise, a systematic review and meta-analysis done in Ethiopia in 2020 showed the pooled prevalence of hypertensive disorder of pregnancy to be 6.82% -(\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eDespite all these, only few published findings are available concerning CVDs during pregnancy in Ethiopia and the national policy of Ethiopia does not give adequate emphasis on the burden of CVDs in pregnancy. Thus, this study is aimed at showing and filling this gap by assessing the burdens of cardiovascular diseases among pregnant women in Jimma University Medical Centre (JUMC). Hence, the findings of the study will be input for reviewing health policies at regional and national level.\\u003c/p\\u003e\"},{\"header\":\"Materials And Methods\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eStudy Area, Design and Period\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe study was conducted in JUMC. JUMC is a tertiary comprehensive hospital located in Jimma town, Southwest Ethiopia. The hospital has a catchment population of 20 million people. The study design was institution based cross-sectional study. \\u0026nbsp;The study commenced from October 2021 to December 2021.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eStudy population\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eWe recruited pregnant women who were in the 3\\u003csup\\u003erd\\u003c/sup\\u003e trimester of pregnancy who were in antenatal care follow up at JUMC during the study period. We used systematic random sampling technique to select the study populations.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eInclusion and Exclusion criteria\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eAll women with confirmed 3rd trimester pregnancy and willing to participate in the study \\u0026nbsp; were included in the study. But, non-pregnant women who came for preconception counseling; those who were in the first and second trimester pregnancy; and those who were in 3\\u003csup\\u003erd\\u003c/sup\\u003e trimester pregnancy but were not willing to give their written consent were excluded from the study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eSample Size determination and sampling technique\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eSample size was calculated using single population formula. The formula and calculation procedure is indicated below:\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cimg src=\\\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAJsAAAA3CAYAAAAbvzgZAAABRWlDQ1BJQ0MgUHJvZmlsZQAAKJFjYGASSSwoyGFhYGDIzSspCnJ3UoiIjFJgf8bAysDFwMOgx8CRmFxc4BgQ4ANUwgCjUcG3awyMIPqyLsgsxfeXxd7cNNdkEZ1fIG2cy4KpHgVwpaQWJwPpP0CcmlxQVMLAwJgCZCuXlxSA2B1AtkgR0FFA9hwQOx3C3gBiJ0HYR8BqQoKcgewbQLZAckYi0AzGF0C2ThKSeDoSG2ovCHC7uPr4KIQamRiaEnAtGaAktaIERDvnF1QWZaZnlCg4AkMpVcEzL1lPR8HIwMiIgQEU5hDVn2+Aw5JRjAMhlv+RgcH8HJBxDCGWMJmBYds7oLe/I8TUghgYBF0YGPYWFCQWJcIdwPiNpTjN2AjC5t7OwMA67f//z+EMDOyaDAx/r////3v7//9/lzEwMN9iYDjwDQAyb18EvFuI5gAAAFZlWElmTU0AKgAAAAgAAYdpAAQAAAABAAAAGgAAAAAAA5KGAAcAAAASAAAARKACAAQAAAABAAAAm6ADAAQAAAABAAAANwAAAABBU0NJSQAAAFNjcmVlbnNob3QQgnNQAAAB1WlUWHRYTUw6Y29tLmFkb2JlLnhtcAAAAAAAPHg6eG1wbWV0YSB4bWxuczp4PSJhZG9iZTpuczptZXRhLyIgeDp4bXB0az0iWE1QIENvcmUgNi4wLjAiPgogICA8cmRmOlJERiB4bWxuczpyZGY9Imh0dHA6Ly93d3cudzMub3JnLzE5OTkvMDIvMjItcmRmLXN5bnRheC1ucyMiPgogICAgICA8cmRmOkRlc2NyaXB0aW9uIHJkZjphYm91dD0iIgogICAgICAgICAgICB4bWxuczpleGlmPSJodHRwOi8vbnMuYWRvYmUuY29tL2V4aWYvMS4wLyI+CiAgICAgICAgIDxleGlmOlBpeGVsWURpbWVuc2lvbj41NTwvZXhpZjpQaXhlbFlEaW1lbnNpb24+CiAgICAgICAgIDxleGlmOlBpeGVsWERpbWVuc2lvbj4xNTU8L2V4aWY6UGl4ZWxYRGltZW5zaW9uPgogICAgICAgICA8ZXhpZjpVc2VyQ29tbWVudD5TY3JlZW5zaG90PC9leGlmOlVzZXJDb21tZW50PgogICAgICA8L3JkZjpEZXNjcmlwdGlvbj4KICAgPC9yZGY6UkRGPgo8L3g6eG1wbWV0YT4KTx2a5AAAE2ZJREFUeAHtnAl8VNX1x78zk0ySyTrZExIgC0kgCYRFIBASwlJkUWxBa6l/+kfBpVWK2lJwxfZvrUsVF9RSERUUkVUEgbDIvkiAyBoCIUAIZN8nmf397wQDkw0CgZQpcz888ua9e8+999zfPffcc859Mkkk7MnOgXbggLwd6rBXYedAHQfsYLMDod04YAdbu7HaXpEdbHYMtBsH7GBrN1bbK3K4c1hgpjrvCBvXrGH38YvUSE4ERicyYtRQenXyxD7rbj0S7hge15zZxQfPTeOvX+xB6x1GuI+J/Yvf4C8vvM+O01W3ntP2GrhDJJtEVVU5Oo94Hpw2hT+Mj8OVau5yepxnvtjAnuPjSQyPwbHdASFh0usxK5Q4KmTtXnt7V2ibYBN2aIPRgMUefem6wjaZTI7cQSGWRTNmM8gVDijkMnyjh/DHvw1C6eqJSmTXnE1nU/o5TL5diQjxaTrrzAa0OlGH3AEHCz1BzCzqs1wymQNKpeJKpS3eiaW7pIAKkws+3l44N+C2ntObFjFv+UEifvUoDw7tVteuFkndjBeSGYNeh9EsE31yRC638EjwUPRNEhxzVCoRrLqSDDUUFxVjUAUQ5OV05fkN3jXo/g3SaNdixrIjLF/0NZszCnFQuePqqsLJQY6FRzILsMy1VFZUUKUx4hzUnwmTxtG3swcKpQovpaWpGrJ3rOC9N+eytzKE305/irvj/erKW3fErLnIsX27+WHLAc6VVKEXgyJzdMHdzQWFyYhZrsS7Y1cGpA6hT0wgztaFxb1UW0D61o3sy6rANyGVoX2twGYo5/Caf/HCK++x7oiRCV2GMbYdwCYZdRQc3cmW3Xs5mJVPrd4gZqMDzq5udRPBYJLj6hlMbP9khgyMx0eq4lzGBtJ+qiIscQQjkrvi1QbFSzFLpEZ8uo1/6slOW8DHC9Io9Yqhd1wUoUGBBAYG4OcfRHCAC+d2LGf+p8vZdrKMwB6pjE5NwFd1SQoZNWdJ++wd/v7uMooCBzP15Zk8lByJi/Vsru+9XI4CPWfSPuMDQe/gORmxg1LoGRWCr6cL2rx0li5cwMofjmPy60K38ACcfx4IQ0UWqz75kG92lxE1bCwj+0fh7SRemrUUnznI0g/+xsx/fMaWE4WYHT3pM/xehos8LvV136q/Fqkvlyg7vZ+FH89jxd6zOAT3YnBiLB381Sj1F9iz6ku+XLqRUxo1cX0S6BYRiktZBos+/Zr9ZR507x6BW2uEenN9sPhGbSWZq7Ok7xZ+Iv37611SkbZRq82VUvrCGdLgMG/J1TdGevCvy6TsauPlTLVFP0n/fmasFBfVSxr3pznS1mOnpdzcXHHlS5Va/eV8DW6MRdKSJ4dLvg4qKW7CPOmURiyi9cmQL301daQUqlBKIQOfldYdK697YyzLlBY9/6CUPOTX0uyNpyXdz/l15TnS6n/+URoaFyqpvfylqB6xUlS4WnJQBkmT310tldTTveV/tdLRda9J/UO8Jf8e90nv7imyqlErndzwqtQ3xEtyCu0nPb00U6qpe6uRflrwJykloZ808fX1UpHBqsh13LZBKDYH3Vv8TOZJjyG/4J6xifhaqxD6QrbNfZ4/zJzD9kp/xj7zJn9/5peEu9ZPwSqydq7ks+W7KRQ6S8mx9bwzYypTJj/KtOlvsPnoRSHDmqaai3v4/uApKlwCSR57F4EqKxHo4EGAjxpXuZHqwgJKKnRi7axi38oPmb3oIO7xYxifFEbdyi1IV104zvpVW7mg7MqEGe/w5cfPMaaHWuhMRqF3Nq37Vj2RqvM4Lpb3s9VyOgvTz+AIN6uqlHj6BeLh7Ii+pozzBVVCN7a8VtH9gccY3xU2z/kb/96cg9aqVGtvbUpnk6n8CbVo99ZJd4G1H73C9NcWcMIcxaQX3uS13w/Ht36U6/I60TnxId5fOgqDySCUZCMmoYNZkoPSg7Bw32Z2omIJ3biWjFMFeIVPZFyfMLGDvZJqTm9h+bZ0cvCj15BBdI/ypfrkOr741wqyHaMZefdgAq0mhEen/kz78EumqYPoHKRGXrqebyw7GPGv/ZJEyZlDrFt/klpVCL1GjSLCx0rbrD3D9mUrOF5UToeYEYwe0BGXeoQoIxl9Xx8+/eFz5r/7NUNin6ZfB6uyrehEPalWZL39ski1eWz+5FVefGMxZ6QoJkx/lVceG9oIaJZ2K/HwD6enuFqdtDls2npEbA4gdGxvofcZKC8rw6CrJOfAJpbMm8ua43ruGv8EM5/6JbHelexbv5EfTpbjGd+BuKiGhmJHlZrwbuor1RtNYgfYzslcwblDG9l7oRyVX0+xsXFFX1GGzqCjVBi81y+ez6eLMnDpei+T//Jn7ov1bzAJ1T0SCPJbwtaMVWw8Mo6eHaIuS+7W9MR2wVZzju/ee4EXZy8lxyGGibPe4sUpQwi8ScayisOb2Hb4BKVKb+JK9/D525mYamuorq6kslKL0ieZZ98ezajh/Qn3FiKs/DjZB9MprJER7hFCJ0/nJjvc1gzI5TzC9KLT6tEJUApby1VoWcw/IovYHTurnHBsYLu4TK3uRl96kT3f76WgWiyMHcykL5rDcZkeTXWV6JMGg8KTEVP/wajRw0mM9hcbpIbJ2acLQR5eaHLOsO3AGR5JjSKwwQrSMH/jXzYJNqnmLKvff5mZs1dyxqEb//v8m7z0SCoBNwloSNWkb9zLkVPl+Pd+kj8++zgJfiZ0luVX2KOcVV54+/qhdr3CPkOVRixR5ZgNTuK9GpWDlX7XmOut+G2xAy75/HM2nCgXtj7FVcFmMslwDejLxMd/Q0pX/xaomyjO3cnajPPovSKYMO1pHhvQCbnF7mYSVjaLacjbFx8ftwbSzJqYXIDR1wJojYHCk4VotALlytb38wq3rKnexvcWoH373ss899ZyLrp055Hn/o+XHx6Mj/UM+9kAK1NcbZBa7qSpNINN+w9ytsaD4SMGMqB/JAEtZ//5jTD4GoVx1GKPE09aPwTNE3ZQedMxuge93TTXVuskGc7eEfi4WymJjckaKsnevInM/GrUMSncO6APMeHujXNd9XedMVt4OoT1BLOYeD+rvVctY/3SpsBmqshm1QezeOndFeS7dWfKS3/n2YeSGwLNVMi+HVmYPCO4KyGoyVJg3fmW7i/u3cWBjHPIAxMZ0juBlmSFdXlHlTMewa4oHMTyV1uJVkiLtiSngGiG/EZcbSFiVVZXfpI0YRMsMniQOGwokYHWu1CrjFe5NUs6NGJ7alIK42+wMFJf50piM6YPU3kmi9+cwfPvr6YwYCDT/vkRsx5OJsBKoplrC9m+4H3mrtgsTAzuNwQ0yGP7jl1k5NTQcVAq/ft2bp2U8vKnU/dY3FQmKjT5XKwR1vnbJkkUHlzLtuO5KHziGTu8OyHWZpxWttOozSdfqAsyNzU9enfEq1lreMvEbECySVTnH2Dh67N4/bPvOWPqxLDEVKKVF9my5pywAxkxCr2j/MIJ9m5JI21fBQMe/QeDu17fzDXUlnMh5xTHti9h/oodFAiTRIChiPOnsoiMDcPH1QrVzfFT4UdMz2EM6PA9mwpzOXy6krtDVC2HLgn7mkFICYudTX+rdqbmWkryc8k6updvZi/j0OlS5GEKynKyOR2upmOgO47Xsd7XZh8kt7QCn86/ZnR8GO7XUdbCMhsAm5maCg1G10hG3D9F+ENd8fDQkpm+Wyi2AmgGvXCY6zEKx7zMO5oRExMYd/9gvK+TESZdNRdzTpBZKCMq9X4iU2Uo3NwpOHmOivCQa4NNwCoobhDjxvXjx3mnObT9CFVJgXi2tHaoIkm9byKGMD1JfYTLrDkAt/WZWPYqC8+SdVy4pboM5NedkoSz3QVTeR65hV0JCRA6W6v5VEPGhh/Jq/Rk6FO/JTHSyozT2nZeh7fhP5bVLEITLNelZJZMJqNkNF659Hq9+G2ShKG2DUnUYRI0xFVP5vLv+getoF55aoM064Ekqf/IJ6RlR8taUeLWZjGbL/XJ1IB/Fl5dR6dEE6tPfC1NSk6QBk14Uzp4g/4qmaWrrQWmPV9rOGCm7Ng6Ppj9OZmuA3n0DxNJjvRqvQBpTRXtnEdzdi+fvDWbXcaePDHjKQZ3ujE53AhsIk6sppKy0lJKSwvJzStF4ZfAoD5BGItPsf/H/ZwslNOlfxK9o4JwaWmJaGdm3H7VSVSc2cfqVRs4pQsgZdRoErsGYQn8sKlk1nHh+C42pO3ionM3Rt8zgnihh95oagg2yUj5qf1sXLucufOXcbhazbiX5zKtez6rFi5n8449HMouwXvoX/jw9ScZENrYxix80aYa8k6e4HRuEbprzWeLUHV0JTiyOzEhYvfYav3hRrvbzuV0peScOkWRPJCosFC8nG2rg1JNMTliM1GiCCZGhBq5X6epozG3G24QRASqZ3hPBiVnMf+DL0Uwoi8h5kOsWVuEb/Jkng52YOZrX1AkFHJzC24Ro7aYg+sX81XaAcokx6sCSBJKPW4dSJ04k/Ag9ytO38attNXfTt6ExfYlzEbbL1P5Eh4rrpvU/oZgE0RlImSmWERz5oiQaIcgXzTna+h9z0MMj3dj+XP5FOiEUTAplvDA5tcEBxd/En81hfDkijrJdtW5bJFsDs54B4fg1EhIig2BmFU5HD58GK1WK4L+mq/vJvHBTuY6OWBR9S1jFBAQSJ8+vYWFwOOaFJqAzVh5ns2rD1AovLXqOB/iR45niAibNuWuIW33ASrUfRnWuyfBjcBRX5NM7oSnfwdU6oBru1nqConYdyfhtG6ESktnzp8/z759+9BoNHaw1TP4NvlbD7bw8HBiYqJvBGxmynM2sfbwWYzqWMZO+B/G9PQTlngzx7ftZP/hUkJGpdC3V2CLXTZozrP+03+xeONPlImDFS2stpfKm0WYjVhGB0/4E78fI8KirYSXQvg1U1JS6q4WK7O/sCkONJRsloMYqzeLHaeJbuOeYPI9CZdO/Ggz2bJnOydNnfldYjyuJeeFj80bX7Vrky2AwtGdiJ5JjHDpJA4CXwtswnHt7EWXCC/aGCRhU0xv0lgR0KkT3gTkjjgpGw5Jk7w2/KBBz2ry01m26RDFRPLIuCQRl3VprazNOsCB3UeoVCVQkydMID8pSUj0FjGqTZNc6UXXpLvF1fSd/UkjDkhazqWnsfTbTZwoqMGikMcOGMMvR/YjxKPB0DQqaJs/rRYuCV1ZEarO0Qx+cDKju4VejsI0y9wJCu1CQpgX6qBQeiX1JcLPOkjaNjv/n221mbMbPmTq1Jf4LltJXP9EolT5rHh7OtPf+pY8TbvGi7cLKxrY2SQRHqwVjm0ULjiLMJLLOrupluKCQqrFYVv/QF9UjlYYbZdm2molYscmfLc6YSoS8bYi1k38JyJqXV2dhC5bS8Y3c/hkp4l7n5zKL7oIq7yIo3vnsYeZX9CP9xe9TUqHG7PU367caiCrZY5OuIirSRLg8w3uhG+TF/YHV+WAQFd17jG2b/uBTVt2cviCkW73/ZmXHk7Cx9mJrvc8xqujHHFzsxwc0XJstzjDkG0mqN9dhHpeI8rkqhXfni/tIupWjotMgSoogri4QPL2/8jO/ZkoAtS41OFIjpOLO54CaIraXDZ8/BJPv7gQXcJvmDF9POE3fBL4VnaobbQbSLa2kbKXbo4DDi6uOGrPUyCcJX7RY7ivbxiqy1PcTFFmGh+9MYe1mQb6T/orT04aTcR/IdAsvLnc7eYYZX92EzhgqCBjzTZyK+XEjBxGdEC9I9tMfvoiZkx5hoUZcu7+/XQeH9sTh6Jz5F4sFqeq/vuCceyS7SbgyZqEvuIip7NOcOJsPkZncSDZt5CVu8UJclVXxiRHXznTajzDhqXL2HyyAtdOlaQve08crdOJqF1HEV4+jKdmPEq89QFi60ps9N4Otps1cOYasnd+x1dLNnHBUZw27yu+AZe7lY/mfcuqY4UEDnmMfpEhV85FyPxInTyLr8ZWI4I0RaTxpUPLlrNZbl5BdGxriMXN6tdNpGMH281gpq6IrQve4LV5W1ANnMyfn3qA3qFeSCU+/CjCtWr0apJG9iEyyGqHqXAnRIRWhUTejAbYBg27ztbWcTJrOLJmDq+8s4T84Ht49unfkdhJfH5KOIUNpbmUl1ehChlASmwk3nc4t+/w7rcZaZRlrmb2OwvJMsbz+LRJJNZ/bEWfT9qXK9mbWUnML1LoHt2cc6+t9dtWeTvY2jJeYqd5dPUqdomPyfgOGEtStw6XtvdC2p1I+5y5S7dzXviZhyX2JuJ6z721pV23aVk72NowMEZx8v3Y4TzKqmWouwTjZTm3pyvh6NZVfPXNOrJLdfj3GUz3zipyRZh8peXbGHdwsm8Q2jD4CkclvoGe4nu64jsaa5eyOLgCtSaXglpHDEo1Cp344IuygIxdP2BKGEiq353t8LODrQ1gk4kQ+JRJk3m4WM+36QdYubiGgSMfYML9fanYqiHjp3NoHVUEd+nN4D5d8LaxAy9tYE2zRRtEfTSbw/7wGhyQ0FYWcuFCCQZnH4KD/XEXn5EyVhaTV1yJzNWHIH/P6/rMwTUqtNnXdrDZ7NDZXsPtGwTbGzObbbEdbDY7dLbXcDvYbG/MbLbFdrDZ7NDZXsPtYLO9MbPZFv8/+bnYSwXL84YAAAAASUVORK5CYII=\\\"\\u003e , Where n is sample size, Z is standard normal distribution value at 95% confidence level of \\u0026alpha;/2= 1.96, P is 10.3% ( Is taken from the prevalence of cardiovascular diseases in St. Paul\\u0026rsquo;s Hospital Millennium Medical College (2)\\u003cstrong\\u003e,\\u0026nbsp;\\u003c/strong\\u003eand\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003ed = margin of error= 5%. Accordingly, the sample size is calculated as:\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;n = (1.96)2 0.103(1-0.103)/0.0025= 141.97=142. We then added 10% non-response rate and got a sample size 156. Hence, we conducted the study on 156 third trimester pregnant women.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData Collection procedure\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eData were collected using structured questionnaire written in English and was translated to the local language the study participant can understand/speak. Data were collected on socio-demographic characteristics (age, education level, occupation, marital status, place of residence, income of the family, religion and ethnicity);and medical, obstetrics and gynecologic factors (hypertension, diabetes, kidney disease, Smoking, gravidity and parity, gestational age, number of living children, contraceptive use and type before the index pregnancy, functional status, previous history of admission and/or treatment due to cardiovascular disease, type of cardiovascular disease, and family history of chronic illnesses).\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eWe used four medical doctors to collect questionnaire data and supervision was done by the principal investigator. The data collectors and supervisor applied COVID-19 precaution rules (Sanitizing hand, wearing gloves and face masks) and the study subjects also used followed the precaution rules. Social distance kept as much as possible\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eBlood pressure, echocardiography and electrocardiography assessment\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eBlood pressure was measured at both arms and the higher was taken. Clinical echocardiography screening was done using My alpha lab (ESAOTE S.p.A ,SN; 50384) and Samsung machines and electrocardiography was done using electrocardiogram machine SE-1200 Express model. These measurements were done after the women took 30 minutes rest.\\u0026nbsp;Urinalysis, renal function tests, liver enzymes and complete blood count were done for those who were hypertensive.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData quality control\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eQuality of data was maintained by one day training of the data collectors. Pretesting of the questionnaire as a pilot was undertaken before the actual data collection. All filled questionnaires were checked for completeness and cleaned manually before the analysis by the principal investigator.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData processing and analysis\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe questioners was coded and entered into Epidata version 3.1statistical software and then exported into Statistical Package for Social Science (SPSS) version 26 for further analysis. Data was summarized and presented using descriptive statistics. Logistic regression was computed to assess statistical association, and significance of statistical association was considered to be significant if P-value \\u0026le; 0.5.\\u003c/p\\u003e\"},{\"header\":\"Result\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eSocio-demographic characteristics of study participants\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe mean age of the study participants was 25.97(\\u0026plusmn;4.6), with a minimum of 18 and maximum of 37 years. Majority of the participant pregnant mothers were from the Oromo ethnic group 96 (61.5%) followed by the Amhara ethnic group (16.7%) and Dawuro (6.4%).The Majority of them were Muslim by religion (54.5%) followed by Orthodox Tewahdo Christian (28.2%) and Protestant (16%).\\u003c/p\\u003e\\n\\u003cp\\u003eThe educational status of the majority of the participants were elementary school (32.1%) followed by higher education (28.8%) and secondary school (28.2).\\u0026nbsp;The occupational status of majority of the participants were housewife (61.5%) and, monthly income of majority of them was not adequate (48.7%).Majority of them were married (99.4%).Most of the study participants were from Jimma Zone, mostly from Jimma town. Socio-demographic data is summarized in table 1.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eObstetric characteristics of the study participant\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eMajority of study participants had 4 ANC visits and about 60%\\u0026nbsp;were two to four gravidity and one to four parity. Concerning contraception uses, about three-fourth were\\u0026nbsp;on contraception methods before the index pregnancy and depo Provera was the most frequently used. The pregnancy was planned in most of them (Please see table 2). \\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMedical History of the study participants\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNine (5.8%) of the study participants had previous admission; of whom three of them were admitted because of cardiovascular disease and six of them were admitted for other than cardiovascular diseases. Five (3.2%) of the study participants were diagnosed to have cardiovascular diseases before the index pregnancy of whom two (1.3%) were hypertensive and three (1.9%) were known to have cardiac disease.\\u003c/p\\u003e\\n\\u003cp\\u003eEight (5.1%) of the study participants had known co-morbid chronic illness other than cardiovascular disease and thirty-three (21.25%) had family history of chronic illness among whom majority had family history of hypertension 26(16.7%). \\u0026nbsp;Among the study participants, 27(17.3%) had dyspnea and most of them were in NYHA class I. The frequency and percent of orthopnea, PND and palpitation were 5(3.2%), 4(2.6%) and 20(12.8%) respectively. The detail of medical history of the women is indicated in supplementary table 1.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003ePhysical Examination Findings of the study participants\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe mean pulse rate of the study participants was 91.62(\\u0026plusmn;10.9). The mean systolic blood pressure was 115.54mmHg (\\u0026plusmn;13.7); the minimum was 90 mmHg and the maximum was 162mmHg. The mean diastolic BP was 74.69mmHg (SD = 10); the minimum was 60mmHg and the maximum was 110mmHg.The mean respiratory rate was 20.72(SD =1.6) with minimum of 20 and maximum of 36.The temperature and oxygen saturation were within normal range for all of the study participants. From the study participants, 16(10.3%) had hypertensive disorders of pregnancy. Please see table 3.\\u003c/p\\u003e\\n\\u003cp\\u003eDuring physical examination of the study participants; two (1.3%) had pale conjunctiva, two (1.3%) had enlarged thyroid gland, one (0.6%) had displaced PMI, nine (5.8%) had murmurs from whom PR and MR were the frequent findings and fifteen (9.6%) had leg edema.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eECHOCARDIOGRAPHY FINDINGS OF THE SUDY PARTICIPANTS\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eEchocardiography findings are summarized in table 4. Most, 121(22.4%), of the study participants had at least one abnormal echocardiography finding and among them 64(41%) had abnormal valvular lesions. Among those with valvular lesions, 5 (3.2%) had chronic rheumatic heart disease whereas 59(37.8%) had physiologic valvular lesions.\\u003c/p\\u003e\\n\\u003cp\\u003eFour (2.6%) study participants had anemia. One study participant had abnormal liver enzyme, AST, and the value was 67(1.8x elevated).The other liver enzymes were within normal range. Five (3.2%) of the study participants had proteinuria.\\u003c/p\\u003e\\n\\u003cp\\u003eAmong hypertensive disorders of pregnancy, preeclampsia was the predominant finding of which preeclampsia with severity features accounted for 37%.\\u0026nbsp;Among those with CRHD, 3.2% were in NYHA class 1 dyspnea, 0.6 % had orthopnea and 1.3% had palpitation.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eElectrocardiogram Findings of the Study Participants\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eTable 5 summarized ECG findings of the study participants. Accordingly, most of the study participants, 132(84.6%), had at least one ECG abnormality from whom\\u0026nbsp;thirty four (21.8%) had sinus tachycardia; two (1.3%) had sinus bradycardia; six (3.8%) had premature ventricular beats and nine (5.8%) had left axis deviation. The result of ECG investigation also indicated that nine (5.8%) of the pregnant mothers had counterclockwise rotation of transition zone, four (2.6%) had left anterior hemi-block, one (0.6%) had LVH and one (0.6%) had short PR interval.\\u003c/p\\u003e\\n\\u003cp\\u003eT wave changes occurred in 103(66%) of the study participants whereas T wave inversion occurred in \\u0026nbsp;83(53.2%) and most of the inversion occurred in V1, 75(48.1%), followed by lead III, 37(23.5%), and V2, 21 (13.5%). Flattening of T wave occurred in 47(30.1%) where most of the flattening occurred in lead III (21.2%). \\u0026nbsp;On the contrary, Q wave occurred in 26(14.7%) of the study participants which was mostly in lead III, 18(11.5%), and aVL, 5(3.2%). Low voltage of the ECG was seen in 16(10.2%) of the study participants mostly in aVF, aVL and lead III.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eOverall prevalence of cardiovascular diseases\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe prevalence of CVDs in our study population is 16. 7. HDP was found in 10.3%; RHD was found in 3.2%; atrial septal aneurem was found in 1.0% and HHD was found is 1.3% (figure 1).\\u0026nbsp;\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eFrom the result of this study, the prevalence of cardiovascular diseases among pregnant mothers attending ANC at JUMC was 16.7%. HDP and CRHD were the predominant findings. Of which HDP accounted for 10.3%, CRHD accounted for 3.2%, atrial septal aneurysm accounted for 1.9% and HHD accounted for 1.3%. Summing up all cardiac conditions together, the prevalence of cardiac disease was 6.4%. The overall prevalence of cardiovascular diseases was higher because of the increased prevalence of hypertensive disorders of pregnancy. In addition, one of the study participants had both HDP and CRHD and, two of the study participants had both HDP and HHD.\\u003c/p\\u003e \\u003cp\\u003eHDP was the predominant finding in this study which occurred in 16(10.3%) of the study participants; of which preeclampsia accounted for 6.4% followed by gestational hypertension which accounted for 2.6% of cases. This findings was higher than the previous study done a decade ago in Jimma University specialized Hospital, in which the overall prevalence of HDP were 8.5% from which severe preeclampsia was the predominant finding (51.9%) (\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e).The same was true in this study also, preeclampsia was the predominant finding which accounted for 62% of cases. The prevalence of preeclampsia in this study was lower than that of the studies done in Dessie referral hospital (8.4%) (\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e)and Mettu Karl referal hospital (12.4%) (\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e). The prevalence of HDP in this study was also higher than a study done in St. Paul\\u0026rsquo;s Hospital Millennium medical college in which the prevalence of HDP was 6.5% (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). But, it was lower than a study done among pregnant women attending ante natal care at Gondar town health Institutions, North West Ethiopia 2017, in which the prevalence of hypertensive disorders of pregnancy was 16.8% (\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eCRHD was the second predominant finding in this study, as it is the common finding in developing countries, occurred in 5(3.2%) of the study participants which was nearly similar to the study conducted in 2017 which reported that prevalence of definite RHD in rural Ethiopia to be 3.7% on population based echocardiographic study in Jimma Zone, South West Ethiopia (\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e). In this study, 5(3.2%) of the study participants had MR (4 moderate and 1 severe), 2(1.3%) of them had MS (1 moderate and 1 severe), 2 (1.3%)of them had TR (1 mild and 1 severe) and 2(1.3%) of them had mild AR. Two patients had moderate pulmonary hypertension. Mitral valve lesions were the commonest findings, from which MR was the predominant finding in contrary to other studies in which MS was the most common rheumatic valvular lesion encountered during pregnancy (\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e). This finding is similar to other studies done in India and Sudan (\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e) in which rheumatic heart disease was the predominant cardiac finding in pregnant mothers. But the prevalence of RHD in this study was higher than the study done in St. Paul\\u0026rsquo;s Hospital ,Ethiopia and, Eritrea which showed to be (2.3%) (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e). In this study the mean age was 25.8 and the range was 23\\u0026ndash;30 which is similar to age range of RHD. Since RHD is the disease of poverty, all of the cases with RHD had no enough income. Among them, 60% had no adequate income and 40% had no income at all.\\u003c/p\\u003e \\u003cp\\u003eThe 3rd predominant finding in this study was atrial septal aneurysm which occurred in 3(1.9%) of the study participants. This finding was lower than that of the study done in Turkey in which the prevalence of atrial septal aneurysm was 5.67% (\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e) .\\u003c/p\\u003e \\u003cp\\u003eThe other major finding in this study was HHD which occurred in 2 (1.3%) of the study participants. Both of those study participants had moderate LVH and grade 1 diastolic dysfunction. This could be due to undiagnosed chronic hypertension with superimposed preeclampsia.\\u003c/p\\u003e \\u003cp\\u003eWhen we see the echocardiography findings, most of them had benign findings; 92(59%) of the study participants had mild pericardial effusion. This is thought to be related to hormone mediated volume retention mostly during the 3rd trimester pregnancy. This result was higher than other studies in which the prevalence of pericardial effusion in 3rd trimester pregnancy was 40% (\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e).Moreover, our study found mild regurgitation 59(37.8%), mostly from the pulmonic valve, which is due to the physiologic change in pregnancy. This finding is similar with Afari HA et al which found valvular regurgitation in tricuspid and pulmonic valves (\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e).The prevalence of LVH in this study was 3.8% which is less than other study in which the prevalence was 5\\u0026ndash;10% (\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e). In this study, 3(1.9%) of the study participants with moderate LVH had hypertensive disorders of pregnancy and 3 (1.9%) of the study participants with mild LVH had normal blood pressure. Blood pressure and LVH had significant correlation at the 0.01 level (2 tailed), Pearson correlation. The ejection fractions of the study participants were within normal range.\\u003c/p\\u003e \\u003cp\\u003eMost of the study participants, 132(84.6%), had at least one ECG abnormality. T wave changes occurred in 103(66%) of the study participants. T wave inversion occurred in 83(53.2%) and most of the inversions occurred in V1,75(48.1%) followed by lead III 37(23.5%) and V2 21 (13.5%).T wave flattening occurred in 47(30.1%) and most of the flattening occurred in lead III 33(21.2%) followed by aVF 15 (9.6%) and V1 10(6.4%).Peaked T wave occurred in 3(1.9%) of the study participants mostly fromV1 to V3.In the above description, the summation of T wave inversion with its components as well as T wave flattening is greater than the total T wave changes because one case may have more than one T wave abnormalities. This is similar to the study done in Nepal among 3rd trimester pregnant women which showed: - T wave inversion occurred mostly in V1 (88.3%), V2 (60%), lead III (43.3%) and T wave flattening occurred mostly in lead III (50%), V3 (30%) and aVF (13.3%) (\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e). This finding is also similar to another study which showed:-T wave inversion occurred mostly in V1 (84%), lead III (54%),V2 (20%) and T wave flattening occurred lead III (26%) and V1 (6%) (\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eSinus tachycardia occurred in 34(21.8%) of the study participants ;this is because heart rate increases progressively with pregnancy, reaching a peak during the 3rd trimester (\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e). Nine (5.8%) had left axis deviation which is similar to other studies (\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e);among them 2 of them had hypertensive disorders of pregnancy and one of them had chronic rheumatic heart disease. One (0.6%) had short PR interval which is common in pregnancy due to physiologic changes and similar findings were seen also in another studies (22,24,25, 26 (\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e). Six (3.8%) of the study participants had premature ventricular beats which is due to physiologic changes of pregnancy but the result of this study was lower than other studies which showed premature beats to be 59%% (\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e).This could be due to the single ECG recording we used for our study as this can miss some PVCs. In this study Low voltage of the ECG was seen in 16(10.2%) of the study participants mostly in aVF, aVL, lead III which is similar finding to another study (30) .Nine (5.8%) pregnant mother had counterclockwise rotation of transition zone, 4 (2.6%) had left anterior hemi-block, 1(0.6%) had LVH and 2(1.3%) had sinus bradycardia.\\u003c/p\\u003e \\u003cp\\u003e Twenty six (16.7%) of the study participants had Q wave in any lead ;mostly occurred in lead III which accounted for 11.5% followed by aVL which accounted for 3.2% and 1.3% in lead 1. Similar finding was seen in a study done in Nepal in which the increased number of Q waves appeared in 3rd trimester pregnancy highly statistically significant in lead III (35%), II(30%) and aVL (18.3%) and statistically significant in lead I(18.3%) (\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e). Another study also showed similar findings with significantly increased occurrence of prominent Q waves in lead III (40%), aVF (38%) and II (26%) in 2nd and 3rd trimester of normal pregnancy (\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003e\\u003cstrong\\u003eStrength and\\u0026nbsp;\\u003c/strong\\u003e\\u003cstrong\\u003eLimitation\\u0026nbsp;\\u003c/strong\\u003e\\u003cstrong\\u003eof the study\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis is the 1\\u003csup\\u003est\\u003c/sup\\u003e prevalence study that included the ECG and echocardiography findings of 3\\u003csup\\u003erd\\u003c/sup\\u003e trimester pregnant mothers and also findings of atrial septal aneurysm. This is the strength of the study. Therefore, it can be used as a base line study and can give an entry point to other researchers for further wider studies in the area. However, it had its own limitation. First, the study was done in a single center with small sample size. Therefore, it is difficult to generalize to larger population. Second, the study lacked follow-up ECG and Echocardiography investigation to see changes of the abnormalities overtime. That limited us from knowing the outcome of the abnormalities.\\u0026nbsp;\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003ePrevalence of cardiovascular diseases among 3rd trimester pregnant women attending ANC follow-up clinic at JUMC was 16.7% of which hypertensive disorders of pregnancy accounts for 10.3% and cardiac diseases accounts for 6.4% .From hypertensive disorders of pregnancy; preeclampsia was the commonest finding accounting for 6.4% followed by gestational hypertension (2.6%). From the cardiac diseases RHD was the predominant finding accounting 3.2% of cases followed by atrial septal aneurysm (1.9%) and HHD (1.3%). In the case of RHD, mitral valve involvement was the predominant finding and MR was the commonest one and 1.3% of them have moderate pulmonary hypertension.\\u003c/p\\u003e \\u003cp\\u003eMost of the ECG findings showed T wave changes, mostly inversion followed by flattening. T wave inversions were commonly seen in V1 (48.5%) followed by lead III (23.5%) and V2 (13.5%). T wave flattening were seen commonly in lead III (21.2%) followed by aVF (9.6%).\\u003c/p\\u003e \\u003cp\\u003eIn the similar manner, the major echocardiography findings among the 3rd trimester pregnant women attending ANC follow-up clinic at JUMC were mild pericardial effusion and mild valvular regurgitation, commonly from pulmonary valve. Most ECG and ECHO findings are physiologic changes of pregnancy. So interpretation should be with consideration of these findings.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eEthics approval and consent to participate\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe study was approved by Jimma University Institute of Health\\u0026apos;s Institutional Review Board. Written informed consent was taken from the study participants.\\u0026nbsp;Written informed consent was obtained from each participant and participant\\u0026rsquo;s anonymity and confidentiality was kept.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for publication\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAvailability of data and materials\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompeting interests\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors declare that they have no competing interests\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis research was funded by Jimma University. The funder had no role in the design of the study; data collection; data interpretation; and writing of the manuscript.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthors\\u0026apos; contributions\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e1 has contributed to the study designs, clinical concepts, document writing and conceptualization, editing final documents, data analyses, and interpretation.\\u003c/p\\u003e\\n\\u003cp\\u003e2 has contributed to the study designs, clinical concepts, document writing and conceptualization, editing final documents.\\u003c/p\\u003e\\n\\u003cp\\u003e3 has contributed to the study designs, clinical concepts, document writing and conceptualization, editing final documents, data analyses, interpretation, preparing and reviewing the whole documents. He is the guarantor.\\u003c/p\\u003e\\n\\u003cp\\u003e4 has contributed to the study designs, clinical concepts, document writing and conceptualization.\\u003c/p\\u003e\\n\\u003cp\\u003e5 has contributed to preparing and reviewing the whole documents.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgement\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors thank all of the participants and data collectors for their contributions.\\u003c/p\\u003e\"},{\"header\":\"Abbreviations\",\"content\":\"\\u003cp\\u003eANC- antenatal care\\u003c/p\\u003e\\n\\u003cp\\u003eAR-Aortic regurgitation\\u003c/p\\u003e\\n\\u003cp\\u003eCVDs-Cardiovascular disease\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eHD-Heart Disease\\u003c/p\\u003e\\n\\u003cp\\u003eHDP-Hypertensive disorders of pregnancy\\u003c/p\\u003e\\n\\u003cp\\u003eHHD-Hypertensive heart disease\\u003c/p\\u003e\\n\\u003cp\\u003eJUMC-Jimma University Medical Center\\u003c/p\\u003e\\n\\u003cp\\u003eMR-Mitral regurgitation\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eMS-Mitral stenosis\\u003c/p\\u003e\\n\\u003cp\\u003eNYHA-New York heart association\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003ePH-Pulmonary hypertension\\u003c/p\\u003e\\n\\u003cp\\u003ePR-Pulmonary regurgitation\\u003c/p\\u003e\\n\\u003cp\\u003ePVCs- Premature ventricular beats\\u003c/p\\u003e\\n\\u003cp\\u003eRHD-Rheumatic Heart Disease\\u003c/p\\u003e\\n\\u003cp\\u003eTR-Tricuspid regurgitation\\u003c/p\\u003e\\n\\u003cp\\u003eVHD-Valvular Heart Disease\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n \\u003cli\\u003ehttps://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)\\u003c/li\\u003e\\n \\u003cli\\u003eBacha D, Abera H, Adem A, Tadesse F, Bekele D. The occurrence and pattern of cardiovascular diseases among pregnant mothers attending Saint Paul\\u0026rsquo;s Hospital in Addis Ababa. Ethiop Med J. 2019;57(4):309\\u0026ndash;14.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eBiswas S, Mandal I, Khan Mandal A. Heart Disease in Pregnancy and its Feto-Maternal outcome. IOSR J Dent Med Sci e-ISSN [Internet]. 2016;15(11):92\\u0026ndash;6. Available from:\\u0026nbsp;\\u003ca href=\\\"http://www.iosrjournals.org\\\"\\u003ewww.iosrjournals.org\\u003c/a\\u003e\\u003c/li\\u003e\\n \\u003cli\\u003eRoos-Hesselink J, Baris L, Johnson M, De Backer J, Otto C, Marelli A, et al. Pregnancy outcomes in women with cardiovascular disease: Evolving trends over 10 years in the ESC Registry of Pregnancy and Cardiac disease (ROPAC). Eur Heart J. 2019;40(47):3848\\u0026ndash;55.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eFarhan HA, Yaseen IF. Heart disease in pregnancy-Clinical pattern and prevalence: Initial data from the first cardio-maternal unit in Iraq. BMC Res Notes [Internet]. 2019;12(1):10\\u0026ndash;3. Available from:\\u0026nbsp;\\u003ca href=\\\"https://doi.org/10.1186/s13104-019-4523-6\\\"\\u003ehttps://doi.org/10.1186/s13104-019-4523-6\\u003c/a\\u003e\\u003c/li\\u003e\\n \\u003cli\\u003eSchmaltz AA, Neudorf U, Winkler UH. Outcome of pregnancy in women with congenital heart disease. Cardiol Young. 1999;9(1):88\\u0026ndash;96.\\u003c/li\\u003e\\n \\u003cli\\u003eOwens A, Yang J, Nie L, Lima F, Avila C, Stergiopoulos K. Neonatal and maternal outcomes in pregnant women with cardiac disease. J Am Heart Assoc. 2018;7(21).\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eGelson E, Johnson M. Effect of maternal heart disease on pregnancy outcomes. Expert Rev Obstet Gynecol. 2010;5(5):605\\u0026ndash;17.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eSalam S, Mushtaq S, Mohi-ud-Din K, Gul I, Ali A. Maternal and fetal outcome in pregnancy with heart disease in tertiary care hospital in India. Int J Reprod Contraception, Obstet Gynecol. 2017;6(9):3947.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eOtto H, S\\u0026aelig;ther SG, Banteyrga L, Haugen BO, Skj\\u0026aelig;rpe T. High prevalence of subclinical rheumatic heart disease in pregnant women in a developing country: An echocardiographic study. Echocardiography. 2011;28(10):1049\\u0026ndash;53.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eBeriye M, Araya F, Ahmed Y, Ali E. Feto-maternal complications and outcomes of pregnant women with valvular heart disease in a Tertiary Center in Ethiopia. 2021;\\u003c/li\\u003e\\n \\u003cli\\u003eTesfa E, Nibret E, Gizaw ST, Zenebe Y, Mekonnen Z, Assefa S, et al. Prevalence and determinants of hypertensive disorders of pregnancy in Ethiopia: A systematic review and meta-analysis. PLoS One [Internet]. 2020;15(9 September):1\\u0026ndash;21. Available from: http://dx.doi.org/10.1371/journal.pone.0239048\\u003c/li\\u003e\\n \\u003cli\\u003eWolde Z, Segni H, Woldie M. Hypertensive disorders of pregnancy in jimma university specialized hospital. Ethiop J Health Sci [Internet]. 2011;21(3):147\\u0026ndash;54. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22434994%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3275872\\u003c/li\\u003e\\n \\u003cli\\u003eTessema GA, Tekeste A, Ayele TA. Preeclampsia and associated factors among pregnant women attending antenatal care in Dessie referral hospital , Northeast Ethiopia : a hospital-based study. 2015;1\\u0026ndash;7.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eBelay AS, Wudad T. Prevalence and associated factors of pre- eclampsia among pregnant women attending anti-natal care at Mettu Karl referal hospital , Ethiopia : cross-sectional study. 2019;1\\u0026ndash;8.\\u003c/li\\u003e\\n \\u003cli\\u003eWalle TA, Azagew AW. Hypertensive disorder of pregnancy prevalence and associated factors among pregnant women attending ante natal care at Gondar town health Institutions, North West Ethiopia 2017. Pregnancy Hypertens [Internet]. 2019;16(March):79\\u0026ndash;84. Available from: https://doi.org/10.1016/j.preghy.2019.03.007\\u003c/li\\u003e\\n \\u003cli\\u003eGemechu T, Mahmoud H, Parry EHO, Phillips DIW, Yacoub MH. Community-based prevalence study of rheumatic heart disease in rural Ethiopia. Eur J Prev Cardiol. 2017;24(7):717\\u0026ndash;23.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eEchocardiography in pregnant women. 2006;(20):169\\u0026ndash;73.\\u003c/li\\u003e\\n \\u003cli\\u003eElfil AMH YK. Epidemiology of Cardiac Disease during Pregnancy in Khartoum Hospital, Sudan. J Womens Heal Care. 2015;04(02):4\\u0026ndash;7.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eK\\u0026uuml;\\u0026ccedil;\\u0026uuml;koğlu MS, Sinan \\u0026Uuml;Y, Yıldızeli B. Ten-year outcome of chronic thromboembolic pulmonary hypertension patients in a tertiary center. Anatol J Cardiol. 2020;23(2):105\\u0026ndash;9.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eAfari HA, Davis EF, Sarma AA. Echocardiography for the Pregnant Heart. Curr Treat Options Cardiovasc Med. 2021;23(8).\\u003c/li\\u003e\\n \\u003cli\\u003eChaudhary S, Saha CG, Sarkar D. Electrocardiographic Changes During Pregnancy at Third Trimester: A Comparative Study. Med J Shree Birendra Hosp. 2016;14(2):41\\u0026ndash;6.\\u003c/li\\u003e\\n \\u003cli\\u003eM S. Electrocradiographic Q RS Axis, Q Wave and T-wave Changes in 2 nd and 3 rd Trimester of Normal Pregnancy. J Clin Diagnostic Res. 2014;\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003e\\u0026nbsp;Angeli F, Angeli E, Verdecchia P. Electrocardiographic changes in hypertensive disorders of pregnancy. Hypertens Res. 2014;37(11):973\\u0026ndash;5.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eSumalatha B, Jyotsna M, Indrani G. Electrocardiographic Changes during Normal Pregnancy. Indian J Cardiovasc Dis Women WINCARS. 2017;02(03):035\\u0026ndash;8.\\u0026nbsp;\\u003c/li\\u003e\\n \\u003cli\\u003eUma V, Devi S. Electrocardiographic Changes during the Third Trimester of Pregnancy : A Cross Sectional Study. Sch Journalof Appl Med Sci [Internet]. 2016;4(8E):3054\\u0026ndash;7. Available from: www.saspublisher.com\\u003c/li\\u003e\\n \\u003cli\\u003eWilliams DS, Mikhova K, Sodhi S. Arrhythmias and Pregnancy: Management of Preexisting and New-Onset Maternal Arrhythmias. Cardiol Clin [Internet]. 2021;39(1):67\\u0026ndash;75. Available from: https://doi.org/10.1016/j.ccl.2020.09.013\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"},{\"header\":\"Tables\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eTable1: Socio-demographic characteristics of 3\\u003csup\\u003erd\\u003c/sup\\u003e trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022.\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellpadding=\\\"0\\\" cellspacing=\\\"0\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"57.523510971786834%\\\"\\u003e\\n \\u003cp\\u003eVariable\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.630094043887148%\\\"\\u003e\\n \\u003cp\\u003eFREQEUNCY\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.846394984326018%\\\"\\u003e\\n \\u003cp\\u003ePERCENT\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"3\\\" valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003eAge\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003e\\u0026le;25\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e83\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e53.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003e26_35\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e68\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e43.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003e\\u0026ge;36\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e3.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"7\\\" valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003eEthnicity\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003eOromo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e96\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e61.5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eAmhara\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e26\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e16.7\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eDawuro\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e10\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e6.4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eYem\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e7\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e4.5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eKaffa\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e7\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e4.5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eGurage\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e3.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eOther\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e3.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"4\\\" valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003eReligion\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003eMuslim\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e85\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e54.5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eOrthodox Tewahdo Christian\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e44\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e28.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eProtestant\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e25\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e16\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eAdventist\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"4\\\" valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003eEducational Status\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003eNo formal education\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e17\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e10.9\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eElementary school\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e50\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e32.1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eSecondary school\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e44\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e28.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eHigher education\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e45\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e28.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"4\\\" valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003eOccupational Status\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003eHousewife\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e96\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e61.5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eMerchant\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e2.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eEmployee\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e45\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e28.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eDaily labourer\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e11\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e7.1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003eMonthly income\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003eAdequate\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e29\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e18.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003eMore than enough\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003eNot adequate\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e76\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e48.7\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003eNo income\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e50\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e32.1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003eMarital Status\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"32.550860719874805%\\\"\\u003e\\n \\u003cp\\u003eMarried\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.5962441314554%\\\"\\u003e\\n \\u003cp\\u003e155\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.81377151799687%\\\"\\u003e\\n \\u003cp\\u003e99.4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"43.42379958246347%\\\"\\u003e\\n \\u003cp\\u003eWidowed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"28.810020876826723%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.76617954070981%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable2 Obstetric profile of 3\\u003csup\\u003erd\\u003c/sup\\u003e trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022.\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellpadding=\\\"0\\\" cellspacing=\\\"0\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"49.92175273865415%\\\"\\u003e\\n \\u003cp\\u003eVariable\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003eFrequency\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003ePercent\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"3\\\" valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eGravidity\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e52\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e33.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e2-4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e92\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e59\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e\\u0026ge;5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e12\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e7.7\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"3\\\" valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eParity\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e62\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e39.7\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e1-4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e93\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e59.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e\\u0026ge;5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eANC visit\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e156\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e100\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"5\\\" valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eNo- of ANC visit\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e24\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e15.4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e19\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e12.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e33\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e21.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e47\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e30.1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e\\u0026gt;4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e33\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e21.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eUse of contraception method before\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e118\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e75.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e38\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e24.4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"4\\\" valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eType of contraceptive Method\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eOCP\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e19\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e12.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003eImplanon\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e45\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e28.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003eDepo provera\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e63\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e40.4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003eIUCD\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"33.333333333333336%\\\"\\u003e\\n \\u003cp\\u003e2.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003ePregnancy\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003ePlanned\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e132\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e84.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003eUnplanned\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e24\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25%\\\"\\u003e\\n \\u003cp\\u003e15.4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 3 Physical examination findings\\u0026nbsp;\\u003c/strong\\u003e\\u003cstrong\\u003eof 3rd trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022.\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellpadding=\\\"0\\\" cellspacing=\\\"0\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"40.59561128526646%\\\"\\u003e\\n \\u003cp\\u003eVariables\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.32601880877743%\\\"\\u003e\\n \\u003cp\\u003eFrequency\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.078369905956112%\\\"\\u003e\\n \\u003cp\\u003ePercent\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"40.59561128526646%\\\"\\u003e\\n \\u003cp\\u003ePale conjunctiva\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.32601880877743%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.078369905956112%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"40.59561128526646%\\\"\\u003e\\n \\u003cp\\u003eEnlarged thyroid gland\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.32601880877743%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.078369905956112%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"40.59561128526646%\\\"\\u003e\\n \\u003cp\\u003eDisplace PMI\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.32601880877743%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.078369905956112%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"4\\\" valign=\\\"top\\\" width=\\\"14.263322884012538%\\\"\\u003e\\n \\u003cp\\u003eMurmurs\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"26.33228840125392%\\\"\\u003e\\n \\u003cp\\u003eMR\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.32601880877743%\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.078369905956112%\\\"\\u003e\\n \\u003cp\\u003e2.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"30.712979890310788%\\\"\\u003e\\n \\u003cp\\u003eMS\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"40.03656307129799%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"29.250457038391225%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"30.712979890310788%\\\"\\u003e\\n \\u003cp\\u003eTR\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"40.03656307129799%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"29.250457038391225%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"30.712979890310788%\\\"\\u003e\\n \\u003cp\\u003ePR\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"40.03656307129799%\\\"\\u003e\\n \\u003cp\\u003e6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"29.250457038391225%\\\"\\u003e\\n \\u003cp\\u003e3.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"14.263322884012538%\\\"\\u003e\\n \\u003cp\\u003eEdema\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"26.33228840125392%\\\"\\u003e\\n \\u003cp\\u003eGrade 1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.32601880877743%\\\"\\u003e\\n \\u003cp\\u003e9\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.078369905956112%\\\"\\u003e\\n \\u003cp\\u003e5.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"14.263322884012538%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"26.33228840125392%\\\"\\u003e\\n \\u003cp\\u003eGrade 2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.32601880877743%\\\"\\u003e\\n \\u003cp\\u003e6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.078369905956112%\\\"\\u003e\\n \\u003cp\\u003e3.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 4: Echocardiography abnormalities\\u0026nbsp;\\u003c/strong\\u003e\\u003cstrong\\u003eof 3rd trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellpadding=\\\"0\\\" cellspacing=\\\"0\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"49.92175273865415%\\\"\\u003e\\n \\u003cp\\u003eVariables\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003eFrequency\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003ePercent\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003eEchocardiography\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eAbnormal\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e121\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e77.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003eValvular lesions\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e64\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e41.0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003eMitral stenosis\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eModerate\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"31.03448275862069%\\\"\\u003e\\n \\u003cp\\u003eSevere\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"3\\\" valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003eMitral regurgitation\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eMild\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e2.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"31.03448275862069%\\\"\\u003e\\n \\u003cp\\u003eModerate\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e2.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"31.03448275862069%\\\"\\u003e\\n \\u003cp\\u003eSevere\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003eAortic regurgitation\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eMild\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003eTricuspid regurgitation\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eMild\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e5.1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"31.03448275862069%\\\"\\u003e\\n \\u003cp\\u003eModerate\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003ePulmonic regurgitation\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003emild\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e57\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e36.5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003eCauses of valvular lesions\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eCRVHD\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e5\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e3.2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"31.03448275862069%\\\"\\u003e\\n \\u003cp\\u003ePhysiologic\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e59\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e37.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003eLVH\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eMild\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e1.9\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"31.03448275862069%\\\"\\u003e\\n \\u003cp\\u003eModerate\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"34.48275862068966%\\\"\\u003e\\n \\u003cp\\u003e1.9\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003eDiastolic dysfunction\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eGrade 1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"49.92175273865415%\\\"\\u003e\\n \\u003cp\\u003eHypertensive heart disease\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003ePulmonary hypertension\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eModerate\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.386541471048513%\\\"\\u003e\\n \\u003cp\\u003ePericardial effusion\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"22.535211267605632%\\\"\\u003e\\n \\u003cp\\u003eMild\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e92\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e59\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"49.92175273865415%\\\"\\u003e\\n \\u003cp\\u003eAtrial septal aneurysm\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"25.039123630672925%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 5 General ECG abnormalities\\u0026nbsp;\\u003c/strong\\u003e\\u003cstrong\\u003eof 3rd trimester pregnant women who were attending ANC follow-up clinic at JUMC, Southwest Ethiopia, 2022.\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" cellpadding=\\\"0\\\" cellspacing=\\\"0\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eVariables\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003eFrequency\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003ePercent\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eSinus tachycardia\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e34\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e21.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eSinus bradycardia\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003ePremature ventricular beats\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e3.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eLeft axis deviation\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e9\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e5.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eShort PR interval\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eCounter clockwise rotation of transition zone\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e9\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e5.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eLeft anterior hemi-block\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e2.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eLVH\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003ePoor R wave progression\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e9\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e5.8\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd rowspan=\\\"3\\\" valign=\\\"top\\\" width=\\\"21.15987460815047%\\\"\\u003e\\n \\u003cp\\u003eP wave\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.9435736677116%\\\"\\u003e\\n \\u003cp\\u003eBiphasic V1 and lead 2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.614420062695924%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.592476489028215%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.689655172413794%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.83300198807157%\\\"\\u003e\\n \\u003cp\\u003eInverted lead 3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.073558648111334%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"24.85089463220676%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"26.242544731610337%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"27.83300198807157%\\\"\\u003e\\n \\u003cp\\u003ePeaked V1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"21.073558648111334%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"24.85089463220676%\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"26.242544731610337%\\\"\\u003e\\n \\u003cp\\u003e1.3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eT wave changes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e103\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e66\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eQ wave changes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e26\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e16.7\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eLow voltage\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e16\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e14.7\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"2\\\" valign=\\\"top\\\" width=\\\"43.1924882629108%\\\"\\u003e\\n \\u003cp\\u003eS1Q3T3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"16.588419405320813%\\\"\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"19.561815336463223%\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd valign=\\\"top\\\" width=\\\"20.657276995305164%\\\"\\u003e\\n \\u003cp\\u003e0.6\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":true,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"Jimma University\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Cardiovascular diseases, pregnancy, electrocardiography, echocardiography, Ethiopia\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-1639429/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-1639429/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003e\\u003cem\\u003eBackground\\u003c/em\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cem\\u003ePregnant women with underlying cardiovascular diseases (CVDs) are at increased risk for adverse maternal and perinatal outcomes due to difficulty in tolerating the physiologic changes of pregnancy.\\u003c/em\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cem\\u003eMaternal CVDs are responsible for 10-15% of maternal death. Rheumatic heart disease is the commonest cardiac disease among pregnant women in developing countries. Despite all this, there is no adequate data on the overall prevalence of cardiovascular diseases among pregnant women in our setup as well as in Ethiopia.\\u003c/em\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cstrong\\u003e\\u003cem\\u003eObjectives \\u003c/em\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cem\\u003eThe aim of the study was to assess the prevalence of cardiovascular diseases among pregnant women who had antenatal care follow up at Jimma University Medical center from October 2021 to December 2021.\\u003c/em\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cstrong\\u003e\\u003cem\\u003eMethods\\u003c/em\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cem\\u003eAn institution based cross sectional study was conducted among pregnant women who had antenatal care follow up at Jimma University Medical Centre. We used systematic random sampling to get sample population. Data were collected by using structured questionnaire; sphygmomanometer, echocardiogram, and electrocardiogram. The data were then entered to Epi data and exported to SPSS Version 26 for statistical analysis. Descriptive data summarizations and presentations were done to find the prevalence of CVDs in the study population.\\u003c/em\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cstrong\\u003e\\u003cem\\u003eResult\\u003c/em\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cem\\u003eA total of 156 pregnant women were enrolled in this study. The overall prevalence of cardiovascular disease was 16.7%; of which 10.3% had hypertensive disorders of pregnancy and 6.4% had cardiac disease. Preeclampsia accounted for 6.4% followed by gestational hypertension (2.6%) and chronic hypertension (1.3%).Chronic rheumatic heart disease accounted for 3.2%.atrial septal aneurysm (1.9%) and hypertensive heart disease (1.3%). In those with rheumatic heart disease, mitral valve lesions were the prominent. T wave abnormalities were the most common electrocardiography finding.\\u003c/em\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cem\\u003eMost, 121(22.4%), of the study participants had at least one abnormal echocardiography finding and among them 64(41%) had abnormal valvular lesions. Among those with valvular lesions, 5 (3.2%) had chronic rheumatic heart disease whereas 59(37.8%) had physiologic valvular lesions.\\u003c/em\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cstrong\\u003e\\u003cem\\u003eConclusion\\u003c/em\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003cem\\u003eThe prevalence of cardiovascular diseases among third trimester pregnant women was high in our setup. So screening all pregnant women with electrocardiography and echocardiography is important.\\u003c/em\\u003e\\u003c/p\\u003e\",\"manuscriptTitle\":\"Prevalence of Cardiovascular Diseases among Pregnant Women Attending Antenatal Care in Jimma University Medical Center, Southwest Ethiopia\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2022-05-10 18:18:42\",\"doi\":\"10.21203/rs.3.rs-1639429/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"c963c427-a7bc-4610-9859-c19df769d74e\",\"owner\":[],\"postedDate\":\"May 10th, 2022\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[{\"id\":12450278,\"name\":\"Cardiac \\u0026 Cardiovascular Systems\"}],\"tags\":[],\"updatedAt\":\"2022-05-10T18:18:42+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2022-05-10 18:18:42\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-1639429\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-1639429\",\"identity\":\"rs-1639429\",\"version\":[\"v1\"]},\"buildId\":\"GqpaHPwrfC8PjnIFayRh5\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}