Study of risk factors and in hospital outcome of patients with Peripartum Cardiomyopathy in a tertiary Hospital of Bangladesh

Abstract

Background: Peripartum cardiomyopathy is an uncommon cause of heart failure associated with pregnancy that can lead high maternal mortality in developing countries. The risk factors and in hospital outcome of this condition remains poorly understood. Methods and Materials: This prospective observational study was conducted from January 2016 to December 2020 in the department of cardiology, Enam Medical College and Hospital, Savar, Dhaka, Bangladesh. PPCM was diagnosed as left ventricular ejection fraction (LVEF) ≤ 45% toward the end of pregnancy or within 05 months after delivery by standard Echocardiographic evaluation. In this study 63 cases of PPCM enrolled, excluding other causes of heart failure. Results: The mean age of the studied populations was 26.0±6.4 years. Study of risk factors were anaemia 22 (34.9%), Chronic hypertension 19(30.2%), pre-eclampsia 13(20.6%), Gestational DM 14(22.2%), dyslipidaemia 10(15.9%), Hypothyroidism 07(11.1%), Primiparity 42(66.6%) and Multiple Pregnancy 21(33.3%). In hospital complications were cardiopulmonary arrest 11(17.4%), pulmonary edema 17(26.9%), cardiogenic shock 28(44.4%), thromboembolism 6(9.5%), need for DC cardioversion 15(23.8%) and mechanical ventilator support 10(15.9%), death was 8(12.7%), discharged with stable heart failure 55(87.3%) and mean hospital stay was 6±2.4 days. Conclusion: This study concluded that risk factors for Peripartum Cardiomyopathy are anemia, chronic hypertension, pre-eclampsia, gestational DM, dyslipidaemia and hypothyroidism and most of them were primipara. All women having clinical features suggestive of heart failure in peripartum period should be evaluated using echocardiography and other diagnostic criteria. Multicenter population-based study needed to find out the incidence and prevalence of PPCM in our population for prevention and control of this condition.