Exploring the Hidden Dangers: Unrevealing the lack of awareness and its causes regarding conception and pregnancy in patients with established Rheumatic Heart Disease (RHD).

Abstract Background: Rheumatic heart disease (RHD), a significant public health concern, is a major contributor to maternal mortality globally, particularly in low- and middle-income countries. Among its numerous complications, RHD poses unique challenges for women of childbearing age. Objective: The aim of the study was to assess the level of awareness regarding conception counseling and the impact of RHD on maternal cardiovascular health in pregnancy in female patients of reproductive age with diagnosed Rheumatic Heart Disease (RHD) coming to the outpatient department of National Institute of Cardiovascular Diseases (NICVD). Methods: This is a cross-sectional descriptive study carried in the outpatient department of NICVD. The study population was women with RHD in the fertile age group. The sampling technique was non-probability, consecutive sampling. Analysis of data were performed with the help of IBM SPSS version 21.Statistical techniques used for the comparison were Chi-square test, Fisher’s Exact Test, or independent sample t-test, appropriately, with <0.05 level of significance. Results: 320 female patients with RHD (diagnosed on the basis of echocardiography) were a part of the survey conducted in the outpatient department. Out of these 320 patients, only 217 women of childbearing age with mean age of 33.5 ± 7.5 were interviewed. A staggeringly high percentage (80.6%) of women of childbearing age between 19 to 49 years had no awareness regarding the impact of RHD on maternofetal health in pregnancy and had received no conception counseling whereas only 19.4% of the women showed some level of awareness regarding it. Conclusion: Level of knowledge and awareness of the impact of RHD on maternofetal health in pregnancy and counseling regarding conception in females of childbearing age with established RHD is alarmingly low. It is ideal for these women to be counseled before conception and risk-stratified according to their clinical state and pathology.