Tamil Nadu Pregnancy and Heart Disease Registry (TNPHDR): design and methodology.

BACKGROUND: Cardiac disease in pregnancy is a major contributor to maternal mortality in high, middle and low-income countries. Availability of data on outcomes of pregnancy in women with heart disease is important for planning resources to reduce maternal mortality. Prospective data on outcomes and risk predictors of mortality in pregnant women with heart disease (PWWHD) from low- and middle-income countries are scarce. METHODS: The Tamil Nadu Pregnancy and Heart Disease Registry (TNPHDR) is a prospective, multicentric and multidisciplinary registry of PWWHD from 29 participating sites including both public and private sectors, across the state of Tamil Nadu in India. The TNPHDR is aimed to provide data on incidence of maternal and fetal outcomes, adverse outcome predictors, applicability of the modified World Health Organization (mWHO) classification of maternal cardiovascular risk and the International risk scoring systems (ZAHARA and CARPREG I & II) in Indian population and identify possible gaps in the existing management of PWWHD. Pregnancy and heart teams will be formed in all participating sites. Baseline demographic, clinical, laboratory and imaging parameters, data on counselling received, antenatal triage and management, peripartum management and postpartum care will be collected from 2500 eligible participants as part of the TNPHDR. Participants will be followed up at one, three and six-months after delivery/termination of pregnancy to document study outcomes. Predictors of maternal and foetal outcome will be identified. DISCUSSION: The TNPHDR will be the first representative registry from low- and middle-income countries aimed at providing crucial information on pregnancy outcomes and risk predictors in PWWHD. The results of TNPHDR could help to formulate steps for improved care and to generate a customised and practical guideline for managing pregnancy in women with heart disease in limited resource settings. TRIAL REGISTRATION: The TNPHDR is registered under Clinical Trials Registry-India ( CTRI/2020/01/022736 ).

(E)-4-Bromo-2-[(2,6-diisopropyl-phen-yl)imino-meth-yl]phenol.

In the title compound, C(19)H(22)BrNO, the dihedral angle between the benzene rings is 76.17 (14)° and an intra-molecular O-H⋯N hydrogen bond with an S(6) graph-set motif is present. One methyl group is disordered over two sets of sites with site occupancies of 0.66 (3) and 0.34 (3). A weak inter-molecular C-H⋯π inter-action is observed in the crystal structure.

2-[(2,6-Diisopropyl-phen-yl)imino-meth-yl]-4-iodo-phenol.

The asymmetric unit of title compound, C(19)H(22)INO, contains two independent mol-ecules. Classical intra-molecular O-H⋯N hydrogen bonds stabilize the mol-ecular structures. The crystal structure is stabilized by weak inter-molecular C-H⋯π and π-π [centroid-centroid = 3.8622 (18) Å] inter-actions. In both mol-ecules, the aromatic rings are nearly perpendicular to each other [dihedral angles = 84.26 (17) and 86.69 (15)°].

2-Bromo-4-chloro-6-[(2,6-diisopropyl-phen-yl)imino-meth-yl]phenol.

There are two molecules in the asymmetric unit of the title compound, C(19)H(21)BrClNO, with dihedral angles between the aromatic rings of 70.0 (2) and 81.9 (3)°. The crystal structure is stabilized by inter-molecular C-H⋯π and C-Br⋯π inter-actions. In additional, the stacked mol-ecules exhibit intra-molecular O-H⋯N hydrogen bonds.