Abstract
Background and Aims: Peripartum cardiomyopathy (PPCM) is an uncommon complication of pregnancy with variable outcome. There is paucity of data related to its outcomes in Nepal. We studied the clinical and echocardiographic outcome of PPCM patients in eastern part of Nepal.Methods: In this prospectively designed study all patients admitted with the diagnosis of acute severe PPCM at Nobel Medical College, Biratnagar, meeting the inclusion criteria over a period of 14 month, were enrolled and followed up for 3 months post partum.The LVEF and Left ventricular end diastolic dimension (LVEDD) was assessed by echocardiography at baseline and 3 months postpartum. Mortality and survival with normal or depressed ejection fraction were determined. Predictors of outcome were evaluated. Statistical analysis were done using SPSS version 17.Results: Mean age of the study population was 27.6}5.6 years. Ninety five percent of patient had term delivery. Sixty four percent were primigravida. Eighty four percent had the symptoms onset in post partum period. Pulmonary edema was present in 64% during first hospital admission. Mortality was 9% during 3-month follow up period. Thirty six percent had complete recovery of LVEF at 3 months. Fifty five percent survived with depressed LVEF. Age, LVEF less than 30% and LVEDD more than 60 mm at study entry did not correlate significantly with poor clinical recovery at 3 months.Conclusion: This study demonstrates that survival outcome is better even in the patients with severe acute PPCM with early diagnosis and proper management of heart failure.
Highlights
Background and AimsPeripartum cardiomyopathy (PPCM) is an uncommon complication of pregnancy with variable outcome
Outcomes of PPCM are markedly variable ranging from complete recovery to surviving with heart failure or death.[3]
Complete recovery was defined as left ventricular ejection fraction (LVEF) more than 50% and recovery with depressed ejection fraction was defined as ejection fraction less than 50%
Summary
Peripartum cardiomyopathy (PPCM) is a rare complication of pregnancy but remains a major cause of maternal morbidity and mortality.[1]. We attempted to evaluate the mortality and survival with depressed/ normal ejection fraction and predictors of these outcomes. Method This prospective observational study was carried out at cardiology unit of department of medicine at Nobel Medical College, Biratnagar over a period of fourteen months from. All consecutive PPCM patients admitted for management of acute heart failure were enrolled in the study. PPCM patients admitted for management of heart failure. The primary end point was the 3-month outcome (mortality verses survival with normal or depressed ejection fraction). The secondary end point was correlation of LVEF, LVEDD and age with the primary outcome. Chi square test was applied to find the significant correlation between the variables and outcome by using SPSS version 17
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