CLINICAL CHARACTERISTICS,ECHOCARDIOGRAPHIC PROFILE AND OUTCOME OF PERIPARTUM CARDIOMYOPATHY AT BPKIHS, A TERTIARY CARE HOSPITAL IN NEPAL


Pandey NK, Karki P, Shah P, Sherpa K

ABSTRACT
Background: Peripartum Cardiomyopathy (PPCM) is a pregnancy assosciated myocardial disease. It is a rare disease with unknown etiology. Certain characteristics are risk factors for the disease. Recognition of its risk factors is important for prevention and treatment.
Objectives: To determine clinical characteristics, echocardiographic profile and in hospital outcome of patients with peripartum cardiomyopathy.
Methods: This is a descriptive retrospective study. All patients files with the diagnosis of peripartum cardiomyopathy from 1st November 2009 to 30th December 2014 were studied. Demographic data, echocardiogram and in hospital outcome of patients were reviewed.
Results: Sixty five patients were diagnosed with PPCM during the study period. Mean age was 28 ± 6.5yrs. Fifty eight patients (89%) were multigravida and only seven (11%) were primigravida. Only two patients had twin pregnancy. Fourty four (68%) presented after delivery and twenty one (32%) presented during pregnancy. Most of the patients 57 (88%) were in NYHA class III and IV. Fifty seven (88%) patients had moderate to severe Left ventricle systolic dysfunction. Five (8%) had preeclampsia, four (6%) had eclampsia and two developed gestational hypertension. Two patients were diabetic. None of the multiparous patients had history of PPCM. No maternal mortality was there. Fetal outcomes were good with all resulting live births and most were appropriate for gestational age.
Conclusions: Patients had varied age and most were multiparous and multigravida. Most of them presented after delivery and had moderate to severe left ventricle systolic dysfunction. In hospital maternal and fetal outcomes were good. 

Keywords: Peripartum cardiomyopathy, Left ventricular systolic dysfunction