Risk factors and Fetomaternal Outcome in Pregnant Women with Peripartum Cardiomyopathy

Sara Mukkaram, Lubna Ali, Rabia Jamil, Farah Husnain, Tayyeba Anbreen

Abstract

Objective

To determine risk factors and fetomaternal outcome in pregnant women with peripartum cardiomyopathy.

Study design

Descriptive cross sectional study.

Place & Duration of study

Department of Obstetrics and Gynaecology Unit II, Civil Hospital Karachi, from January 2018 to December 2018.

Methodology

Women with the diagnosis of peripartum cardiomyopathy, irrespective of age and parity were enrolled after taking an informed consent. Women with the history of valvular heart disease and anemia were excluded.

Results

A total of 63 pregnant women with peripartum cardiomyopathy were enrolled in the study. The mean age and gestational age was 31.75±3.90 year and 35.46±3.10 weeks respectively. The mean BMI was 26.27±4.12 kg/m2 and the mean ejection fraction was 36.26±7.07%. Eleven (17.5%) patients were primigravida and 23 (36.5%) women had two to four children. Parity of >4 was found in 29 (40.5%) patients. Pre-eclampsia was found in 47 (74.6%) and chronic hypertension in 16 (25.4%) women. Sixty (95.2%) women had singleton pregnancy and twin pregnancy was found in 3 (4.8%) women.

Out of the total, 48 (76.2%) women underwent cesarean section due to heart failure and pulmonary edema and 15 (23.8%) had spontaneous vaginal delivery. Fifty-two (82.53%) babies were born alive and 11 (17.47%) were stillbirth. There were 15 (23.09%) maternal deaths due to different reasons.

Conclusion

Peripartum cardiomyopathy is a serious condition of unknown cause that affects women of childbearing age. It is associated with high morbidity and mortality. Diagnosis of disease is challenging and requires vigilance. The successful management demands close cooperation between the patient, obstetrician, cardiologist and the family.

Key words

Feto-maternal outcome, Echocardiography, Peripartum cardiomyopathy, Maternal mortality, Stillbirth, Cesarean section.