The Spectrum of RHD Management in Pregnancy on Assessing the Time of Diagnosis, Severity of Cardiac Lesions, and the Challenges

Rheumatic heart disease (RHD) poses a significant challenge during pregnancy, especially in lowand middle-income countries, where it affects millions of individuals, primarily young women of childbearing age.This autoimmune condition, often triggered by group A streptococcal infections, leads to chronic inflammation and scarring of heart valves, resulting in insufficiency and stenosis.Pregnancies complicated by cardiovascular diseases, including RHD, contribute to maternal mortality rates and present unique management dilemmas due to the physiological changes accompanying gestation.This case series presents three cases illustrating the complexities of managing RHD during pregnancy.Case 1 describes a gravid woman with a history of previous normal delivery and hepatitis B surface antigen positivity, requiring emergency intervention due to fetal distress and elevated blood pressure.Case 2 details the management of RHD in a woman with hypothyroidism presenting with labor pain at term gestation.Case 3 presents the challenges of managing RHD in a primigravida with a history of nephroureterectomy for ectopic ureter insertion.Understanding the pathological mechanisms and tailored management strategies for pregnant women with RHD is crucial for improving care and outcomes.