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. 2020 Dec;13(4):179-184.
doi: 10.1177/1753495X19851397. Epub 2019 Jun 17.

Peripartum cardiomyopathy: An analysis of clinical profiles and outcomes from a tertiary care centre in southern India

Aditya John Binu  1 , Sudha Jasmine Rajan  1 , Swati Rathore  2 , Manisha Beck  2 , Annie Regi  2 , Viji Samuel Thomson  3 , Sowmya Sathyendra  1
Affiliations

Peripartum cardiomyopathy: An analysis of clinical profiles and outcomes from a tertiary care centre in southern India

Aditya John Binu et al. Obstet Med. 2020 Dec.

Abstract

Peripartum cardiomyopathy is a syndrome of maternal heart failure with decreased left ventricular ejection fraction affecting maternal and fetal well-being. We analysed clinical profiles and outcomes in women with peripartum cardiomyopathy enrolled retrospectively from a tertiary care centre in southern India (1 January 2008-31 December 2014). The incidence of peripartum cardiomyopathy was one case per 1541 live births. Fifty-four women with a mean age of 25.5 years and mean gestational age of 35.4 weeks were recruited; 35 were primigravidae. Maternal and fetal deaths occurred in 9.3% and 24.1% of subjects, respectively. Mild-to-moderate maternal anaemia (80-110 g/L) was associated with fetal mortality (p = 0.02). Reduced left ventricular ejection fraction (<30%, p = 0.04) and cardiogenic shock (p = 0.01) were significantly associated with adverse maternal outcomes. Forty per cent of women were followed up after 24.2 ± 17.7 months, and in these women a significant increase in left ventricular ejection fraction was seen (mean 16.4%, p < 0.01); all were asymptomatic. Peripartum cardiomyopathy with poor left ventricular ejection fraction and shock is associated with adverse maternal outcomes, while non-severe maternal anaemia predisposes to adverse fetal outcomes. Significant left ventricular ejection fraction recovery occurred on follow-up.

Keywords: Peripartum cardiomyopathy; heart failure; pregnancy.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart depicting recruitment into the study and follow-up.
Figure 2.
Figure 2.
Comparison of ejection fraction at baseline and on follow-up (mean duration of follow-up = 24.2 months).
See this image and copyright information in PMC

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