Rheumatic heart disease in pregnancy: Strategies and lessons learnt implementing a population-based study in Australia

Vaughan, G; Tune, K; Peek, MJ; Pulver, LJ; Remenyi, B; Belton, S; Sullivan, EA

Rheumatic heart disease in pregnancy: Strategies and lessons learnt implementing a population-based study in Australia

Vaughan, G

Tune, K Peek, MJ Pulver, LJ Remenyi, B Belton, S Sullivan, EA

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Publication Type:: Journal Article
Citation:: International Health, 2018, 10 (6), pp. 480 - 489
Issue Date:: 2018-01-01

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Field	Value	Language
dc.contributor.author	Vaughan, G https://orcid.org/0000-0002-0132-9946	en_US
dc.contributor.author	Tune, K	en_US
dc.contributor.author	Peek, MJ	en_US
dc.contributor.author	Pulver, LJ	en_US
dc.contributor.author	Remenyi, B	en_US
dc.contributor.author	Belton, S	en_US
dc.contributor.author	Sullivan, EA https://orcid.org/0000-0002-8718-2753	en_US
dc.date.available	2018-06-02	en_US
dc.date.issued	2018-01-01	en_US
dc.identifier.citation	International Health, 2018, 10 (6), pp. 480 - 489	en_US
dc.identifier.issn	1876-3413	en_US
dc.identifier.uri	http://hdl.handle.net/10453/129772
dc.description.abstract	© The Author(s) 2018. Background: The global burden of rheumatic heart disease (RHD) is two-to-four times higher in women, with a heightened risk in pregnancy. In Australia, RHD is found predominantly among Aboriginal and Torres Strait Islander peoples. Methods: This paper reviews processes developed to identify pregnant Australian women with RHD during a 2-year population-based study using the Australasian Maternity Outcomes Surveillance System (AMOSS). It evaluates strategies developed to enhance reporting and discusses implications for patient care and public health. Results: AMOSS maternity coordinators across 262 Australian sites reported cases. An extended network across cardiac, Aboriginal and primary healthcare strengthened surveillance and awareness. The network notified 495 potential cases, of which 192 were confirmed. Seventy-eight per cent were Aboriginal and/or Torres Strait Islander women, with a prevalence of 22 per 1000 in the Northern Territory. Discussion: Effective surveillance was challenged by a lack of diagnostic certainty, incompatible health information systems and varying clinical awareness among health professionals. Optimal outcomes for pregnant women with RHD demand timely diagnosis and access to collaborative care. Conclusion: The strategies employed by this study highlight gaps in reporting processes and the opportunity pregnancy provides for diagnosis and re/engagement with health services to support better continuity of care and promote improved outcomes.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/1024206
dc.relation.ispartof	International Health	en_US
dc.relation.isbasedon	10.1093/inthealth/ihy048	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Rheumatic Heart Disease	en_US
dc.subject.mesh	Pregnancy Complications, Cardiovascular	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Oceanic Ancestry Group	en_US
dc.subject.mesh	Pregnant Women	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Public Health Surveillance	en_US
dc.title	Rheumatic heart disease in pregnancy: Strategies and lessons learnt implementing a population-based study in Australia	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	10	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Students
utslib.copyright.status	closed_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	10	en_US

Abstract:

© The Author(s) 2018. Background: The global burden of rheumatic heart disease (RHD) is two-to-four times higher in women, with a heightened risk in pregnancy. In Australia, RHD is found predominantly among Aboriginal and Torres Strait Islander peoples. Methods: This paper reviews processes developed to identify pregnant Australian women with RHD during a 2-year population-based study using the Australasian Maternity Outcomes Surveillance System (AMOSS). It evaluates strategies developed to enhance reporting and discusses implications for patient care and public health. Results: AMOSS maternity coordinators across 262 Australian sites reported cases. An extended network across cardiac, Aboriginal and primary healthcare strengthened surveillance and awareness. The network notified 495 potential cases, of which 192 were confirmed. Seventy-eight per cent were Aboriginal and/or Torres Strait Islander women, with a prevalence of 22 per 1000 in the Northern Territory. Discussion: Effective surveillance was challenged by a lack of diagnostic certainty, incompatible health information systems and varying clinical awareness among health professionals. Optimal outcomes for pregnant women with RHD demand timely diagnosis and access to collaborative care. Conclusion: The strategies employed by this study highlight gaps in reporting processes and the opportunity pregnancy provides for diagnosis and re/engagement with health services to support better continuity of care and promote improved outcomes.

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http://hdl.handle.net/10453/129772