STUDY PROTOCOL Disease burden and adverse pregnancy outcomes due to cardiovascular conditions complicating pregnancy in Sri Lanka: a protocol [version 1; peer review: 1 not approved] Ayesh Hettiarachchi 1 , Niroshan Lokunarangoda 2 , Thilini Agampodi 1 , Suneth Agampodi 1 1 Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, 5008, Sri Lanka 2 Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, 5008, Sri Lanka First published: 11 Oct 2021, 10:1028 https://doi.org/10.12688/f1000research.52539.1 Latest published: 11 Oct 2021, 10:1028 https://doi.org/10.12688/f1000research.52539.1 v1 Abstract Background Cardiovascular diseases (CVD) are the commonest indirect medical cause of maternal deaths worldwide, both in high-income and low and middle-income countries. To minimize the effects of CVD in pregnancy, proper risk assessment and appropriate referral is required. In Sri Lanka, cardiovascular disease complicating pregnancy is a significant cause of maternal mortality, second only to postpartum hemorrhage. Screening for CVD in pregnancy in Sri Lanka is limited to a routine clinical assessment. Evidence-based guidelines are yet to be developed, and this deficit may have resulted in a substantial underestimation of the CVD burden. This study aims to determine the burden of CVD in early pregnancy and develop a risk prediction model to be used in field pregnancy clinics in Sri Lanka to reduce CVD effects in pregnancy. Methods A prospective cohort study was carried out in the Anuradhapura district, Sri Lanka. Following registration to the antenatal care, pregnant women fulfilling the eligibility criteria were invited to attend a special clinic at their relevant Medical Officer of Health (MOH) area. Risk assessment was done through history and a clinical examination, and suspected/probable cases were referred for an echocardiogram by a consultant cardiologist. All the recruited participants in the first trimester were prospectively followed up and screened again between 24–28 weeks of the period of amenorrhoea (POA). Antenatal ward admissions with CVD complicating pregnancy will be extracted, and a telephone interview will be carried out between 6–12 weeks after the expected delivery date to cover postpartum morbidities. Discussion Open Peer Review Reviewer Status Invited Reviewers 1 version 1 11 Oct 2021 report Anish Keepanasseril , Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India 1. Any reports and responses or comments on the article can be found at the end of the article. Page 1 of 10 F1000Research 2021, 10:1028 Last updated: 11 NOV 2021