Evaluation of Adequate Antepartum Care for the Cardiac Patient

In reviewing the causes of maternal deaths in the Department of Obstetrics at the Cook County Hospital, we found that in an 11 year period only three women with adequate antepartum care had died of heart disease and its complications. In the same period however, 21 pregnant women with cardiac disease who had inadequate or no antepartum care died. This seemed to us significant enough to warrant a careful study of the value of antepartum care to pregnant women with cardiac disease. The Department of Obstetrics at the Cook County Hospital has had a special clinic for pregnancy-complicating heart disease since 1925. In 1935 one of us (J.E.F.) 1 reported on 126 closely controlled pregnant women with heart disease. In 1937 Engbring and Sutton 2 reported on the clinic. There was one death from malignant endocarditis in these two groups of patients who had been under the constant direction of