Open AccessA Study of Incidence and outcome of Peripartum Cardiomyopathy in a Tertiary Care Teaching Hospital
Author(s) -
Spandana Kanaparthi,
Suresh Jana,
Ravider Reddy Kasturi,
Nikhil Mudgalkar
Publication year - 2021
Publication title -
perspectives in medical research
Language(s) - English
Resource type - Journals
eISSN - 2348-229X
pISSN - 2348-1447
DOI - 10.47799/pimr.0902.13
Subject(s) - peripartum cardiomyopathy , medicine , palpitations , heart failure , incidence (geometry) , ejection fraction , pregnancy , etiology , population , pediatrics , cardiology , cardiomyopathy , obstetrics , physics , environmental health , biology , optics , genetics
Background: Heart failure in women associated withpregnancy and the peripartum period is now recognized as adistinctive form of cardiomyopathy. Its prevalence andmortality vary in different geographical locations. There is apaucity of data from our group of the population regardingperipartum cardiomyopathy hence we conducted the studyto determine the incidence, aetiology of PPCM in our studygroup along with treatment and maternal outcomes.Methods: Patients with any parity and age, which are in theirperipartum period i.e. one month before delivery or withinfive months of delivery. Patients presenting with moderate tosevere breathlessness at rest or on exertion with palpitations,ankle oedema, or with signs and symptoms of heart failure.Documented systolic dysfunction with the echocardiographicfinding of Ejection fraction of <45% and or Fractionalshortening <30%, absence of another identifiable cause forthe HF.Results: Overall incidence of PPCM in our institution is 9 per1000 deliveries. Among n=67 PPCM cases, n=26 patients(38.80%) developed PPCM during pregnancy and n=41 patients(61.2%) during postpartum period. The majority of the patientsn=49 cases (73.13%) had severe left ventricular systolicdysfunction (EF =30%) and n=10 (14.92%) had moderate leftventricular systolic dysfunction and n=8 had mild LVdysfunction. There was no significant statistical difference inthe severity of LV dysfunction between primi and multiparouswomen.Conclusion: The main factors are advanced maternal age andmultiparity. Twin pregnancies are also risk factors for thedevelopment of PPCM. Yet another important risk factor wasPre-eclampsia. There is no single explanation for thepathogenesis of PPCM that is relevant for all women.Recognition of symptoms of breathlessness, orthopnea, andpedal edema in the post-partum period with a history of preeclampsia should arouse a high degree of suspicion.