Факторы риска развития перипартальной кардиомиопатии

Abstract

Study Objective: To assess risk factors of peripartum cardiomyopathy (PCMP) based on the past medical history, genetic predisposition and peculiarities if this pregnancy. Study Design: retrospective cohort case study. Materials and Methods. We have performed a retrospective analysis of pregnancies and labours of 13 patients at V.A. Almazov National Medical Research Centre with PCMP in 2012–2019. For diagnostics and differential diagnosis, we used general, laboratory and instrumental test methods. Results. We have identified such risk factors as family history of cardiovascular pathologies (61.5%), age 35+ years (53.8%), obesity (53.8%), first labour (46.2%), preeclampsia (38.4%), caesarean delivery (23.1%), gestational diabetes mellitus (15.4%), multiple fetation (15.4%), and history of smoking (15.4%). 76.9% of patients had PCMP developed during pregnancy; 23.1% — on day 1–3 postpartum; a significant factor was operative delivery due to obstetrical symptoms; in one case, caesarean section was followed by a massive blood loss resulting from normal placenta abruption. Prevention of preeclampsia with drugs was indicated for one woman, although in 15.4% of patients it was diagnosed during the previous pregnancy, and 38.4% of women had preeclampsia during the current pregnancy. Conclusion. PCMP is a rare pathology with poorly studied ethiology and high risk of maternal mortality. When analysing clinical cases of 13 patients hospitalised with PCMP to V.A. Almazov National Medical Research Centre, we found out a significant number of PCMP risk factors; however, we have not identified any clear evidence of the impact from a certain factor. An important conclusion is the relation between PCMP and preeclampsia, which can be seen both in our study and in studies by foreign researchers; it is a potential platform for further research of this phenomenon. Keywords: peripartum cardiomyopathy, risk factors, pregnancy, labour