title: Pre-conception counselling for key cardiovascular conditions in Africa: optimising pregnancy outcomes.
abstract: The World Health Organisation (WHO) supports pre-conception care (PCC) towards improving health and pregnancy outcomes. PPC entails a continuum of promotive, preventative and curative health and social interventions. PPC identifies current and potential medical problems of women of childbearing age towards strategising optimal pregnancy outcomes, whereas antenatal care constitutes the care provided during pregnancy. Optimised PPC and antenatal care would improve civil society and maternal, child and public health. Multiple factors bar most African women from receiving antenatal care. Additionally, PPC is rarely available as a standard of care in many African settings, despite the high maternal mortality rate throughout Africa. African women and healthcare facilitators must cooperate to strategise cost-effective and cost-efficient PPC. This should streamline their limited resources within their socio-cultural preferences, towards short- and long-term improvement of pregnancy outcomes. This review discusses the relevance of and need for PPC in resource-challenged African settings, and emphasises preventative and curative health interventions for congenital and acquired heart disease. We also consider two additional conditions, HIV/AIDS and hypertension, as these are two of the most important co-morbidities encountered in Africa, with significant burden of disease. Finally we advocate strongly for PPC to be considered as a key intervention for reducing maternal mortality rates on the African continent.
authors.affiliation: Departments of Paediatric Cardiology and Medicine, Red Cross War Memorial Children's and Groote Schuur Hospitals, Cape Town, South Africa. Email: liesl.zuhlke@uct.ac.za.
authors.forename: Liesl
authors.initials: L
authors.lastname: Zühlke
authors.affiliation: Department of Medicine, Division of Hospital Internal Medicine, Mayo Clinic Hospital, Saint Mary's Campus, Rochester, Minnesota, USA.
authors.forename: Letitia
authors.initials: L
authors.lastname: Acquah
mesh_terms: D000349:Africa; D002319:Cardiovascular System / Q000503:physiopathology; D003376:Counseling / Q000379:methods; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care