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- DOI 10.18231/j.ijogr.v.12.i.3.28
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Peripartum cardiaomyopathy (PPCM): A 5 years experience at a tertiary centre
Background: In developed countries, maternal heart disease is one of the leading cause of maternal mortality, not only due to an increasing number of women with congenital heart disease (CHD) reach childbearing age but also because of the trend to delay motherhood until later in life, when medical comorbidities, such as chronic hypertension, diabetes, and obesity become more common. In low- to middle-income countries, common contributors to maternal death due to heart disease are typically rheumatic heart disease, cardiomyopathies such as peripartum cardiomyopathy, and uncorrected CHD. The purpose of this study is to identify the clinical risk factors associated with Peripartum Cardiomyopathy and the maternal and fetal outcomes in affected patients.
Materials and Methods: This is a 2 year prospective observational study conducted at a teaching institute and research center BLDE (DU) SHRI B.M. Patil Medical College Hospital and Research Center, Vijayapura from 1st Jan 2022 to 31st Dec 2023. All patients in their peripartum period diagnosed with cardiac failure by clinical and echocardiographic criteria were included in the trial. All the patient who were included underwent complete clinical examination and laboratory evaluation.
Results: A total of 35 women were diagnosed with Peripartum cardiomyopathy (PPCM) during the study period. It was mainly seen in patients between 35-37 weeks followed by 38-40 weeks. LSCS patients were more prone to Peripartum cardiac dysfunction than vaginal delivery patients. The ejection fraction was in the range of 36 - 40% in 37.1% of patients. However, mean EF was 35.94 ± 7.92. The most common risk factor was Eclampsia (40%) and second was post-partum hemorrhage leading to shock. The associated complications like Acute Renal Failure (ARF), Disseminated Intravascular Coagulation (DIC), HELLP syndrome, Thrombocytopenia were studied.
Conclusion: Eclampsia and postpartum hemorrhage are the leading contributors to the development of PPCM in this population. The findings underscore the importance of heightened surveillance in women with hypertensive disorders or significant obstetric complications. Early screening with echocardiography, particularly in high-risk pregnancies, can aid in prompt diagnosis and intervention. A multidisciplinary approach involving obstetricians, cardiologists, and intensivists is essential for improving maternal and fetal outcomes. Continued research and awareness are vital to developing region-specific protocols to reduce the burden of PPCM-related complications.
References
- Sliwa K, van der Meer P, Petrie MC, Baris L, El Hajjaji I, Van Spall HGC, et al. Risk stratification and management of women with cardiomyopathy/heart failure planning pregnancy or presenting during/after pregnancy: a position statement from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy. Eur J Heart Fail. 2021;23(4):527–40.
- Mogos MF, Piano MR, McFarlin BL, Salemi JL, Liese KL, Briller JE. Heart failure in pregnant women: a concern across the pregnancy continuum. Circ Heart Fail. 2018;11(1):e004005.
- Sliwa K, Baris L, Sinning C, Zengin-Sahm E, Gumbiene L, Yaseen IF, et al. Pregnant women with uncorrected congenital heart disease: heart failure and mortality. JACC Heart Fail. 2020;8(2):100–10.
- Carlson S, Schultz J, Ramu B, Davis MB. Peripartum cardiomyopathy: risks diagnosis and management. J Multidiscip Healthc. 2023:1249–58.
- Honigberg MC, Riise HKR, Daltveit AK, Tell GS, Sulo G, Igland J, et al. Heart failure in women with hypertensive disorders of pregnancy: insights from the cardiovascular disease in Norway project. Hypertension. 2020;76(5):1506–13.
- Pfaller B, Sathananthan G, Grewal J, Mason J, D'Souza R, Spears D, et al. Preventing complications in pregnant women with cardiac disease. J Am Coll Cardiol. 2020;75(12):1443–52.
- American Heart Association. Peripartum cardiomyopathy (PPCM) [Internet]. Dallas (TX): American Heart Association. Available from: https://www.heart.org/en/health- Patil et al. / Indian Journal of Obstetrics and Gynecology Research 2025;12(3):534–539 539 topics/cardiomyopathy/what-is-cardiomyopathy-in- adults/peripartum-cardiomyopathy-ppcm.
- Aryan L, Medzikovic L, Umar S, Eghbali M. Pregnancy-associated cardiac dysfunction and the regulatory role of microRNAs. Biol Sex Differ. 2020;11(1):14.
- Sigauke FR, Ntsinjana H, Tsabedze N. Peripartum cardiomyopathy: a comprehensive and contemporary review. Heart Fail Rev. 2024;29(6):1261–78.
- Daubert MA, Douglas PS. Primary prevention of heart failure in women. JACC Heart Fail. 2019;7(3):181–91.
- Pearson GD, Veille JC, Rahimtoola S, Hsia J, Oakley CM, Hosenpud JD, et al. Peripartum cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review. JAMA. 2000;283(9):1183–8.
- Goland S, Schwartzenberg S, Fan J, Kozak N, Khatri N, Elkayam U. Monitoring of anti-Xa in pregnant patients with mechanical prosthetic valves receiving low-molecular-weight heparin: peak or trough levels? J Cardiovasc Pharmacol Ther. 2014;19(5):451–6.
- Devabhaktuni P, Manchala S, Raju SB, Menon R, Sridevi C. Chronic rheumatic heart disease and congenital heart disease complicating pregnancy: a study of the cardiac events, the maternal and perinatal outcome during 2011-2013 at tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2020;9(7):2736–45.
- Ali A, Ahmad F, Danish SH, Zahid N, Israr N, Farooq S. Healthcare system of Pakistan: strengths and weaknesses. Adv Res. 2021;22(2):45–9.
- Leon LJ, McCarthy FP, Direk K, Gonzalez-Izquierdo A, Prieto- Merino D, Casas JP, et al. Preeclampsia and cardiovascular disease in a large UK pregnancy cohort of linked electronic health records: a CALIBER study. Circulation. 2019;140(13):1050–60.
How to Cite This Article
Vancouver
Patil NG, Yaliwal RG, Shiragur SS, Mathapati SS, Biradar AM. Peripartum cardiaomyopathy (PPCM): A 5 years experience at a tertiary centre [Internet]. Indian J Obstet Gynecol Res. 2025 [cited 2025 Oct 03];12(3):534-539. Available from: https://doi.org/10.18231/j.ijogr.v.12.i.3.28
APA
Patil, N. G., Yaliwal, R. G., Shiragur, S. S., Mathapati, S. S., Biradar, A. M. (2025). Peripartum cardiaomyopathy (PPCM): A 5 years experience at a tertiary centre. Indian J Obstet Gynecol Res, 12(3), 534-539. https://doi.org/10.18231/j.ijogr.v.12.i.3.28
MLA
Patil, Neelamma G, Yaliwal, Rajasri G, Shiragur, Shobha S, Mathapati, Sangamesh Sharanayya, Biradar, Aruna Mallangouda. "Peripartum cardiaomyopathy (PPCM): A 5 years experience at a tertiary centre." Indian J Obstet Gynecol Res, vol. 12, no. 3, 2025, pp. 534-539. https://doi.org/10.18231/j.ijogr.v.12.i.3.28
Chicago
Patil, N. G., Yaliwal, R. G., Shiragur, S. S., Mathapati, S. S., Biradar, A. M.. "Peripartum cardiaomyopathy (PPCM): A 5 years experience at a tertiary centre." Indian J Obstet Gynecol Res 12, no. 3 (2025): 534-539. https://doi.org/10.18231/j.ijogr.v.12.i.3.28