title: Pregnancy follow-up in a patient with mechanical valve: possible in sub-Saharan Africa?
abstract: BACKGROUND
  In Africa in general and in Cameroon in particular, post rheumatic cardiopathies are a health care problem, one of the causes of infertility in the women population and a major cause of death among children and adults. Management of a pregnant woman with mechanical heart valve is a complex issue for all health care providers involved in the care of such patients.
  Miss A is 26-years old and consulted for cardiac assessment; referred from Bamenda (North-West province of Cameroon) for better management of a cardiac problem including arrhythmia and a history of recurrent tonsillitis. The cardiac echo-dopplerography showed severe post-rheumatic mitral valve regurgitation with pulmonary hypertension and a dysfunctional left ventricle. The patient was later evacuated in a surgical centre in Milan San Donato (Italy) where a St. Jude mechanical heart valve N.27 was implanted. Two years after surgery, during a follow-up visit, the patient brought a pelvic ultrasound showing a single live intrauterine foetus, gestational age estimated at 7 weeks.
  
  
  CONCLUSIONS
  Management of mechanical valve in a pregnancy context, resulting in a favourable outcome (no thromboembolic events and the delivery of a healthy baby) is possible in sub-Saharan Africa. Close observation, adherence to existing clinical guidelines, patient cooperation and an appropriate technical infrastructure are critical factors to consider.
authors.affiliation: Shisong Cardiac Centre, Kumbo, Cameroon.
authors.forename: Jacques Cabral Tantchou
authors.initials: JC
authors.lastname: Tchoumi
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Ambassa
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Butera