Global Advanced Research Journal of Pharmacy and Pharmacology (GARJPP)
September 2012 Vol. 1(1), pp. 001-011
Copyright © 2012 Global Advanced Research Journals

 

Full Length Research

Peripartum cardiomyopathy: risk factors, hospital course and prognosis; experiences at Lady Reading Hospital Peshawar

Ibrahim Shah1*, Shahzeb2, Mohammad Hafizullah3, Syed Tahir Shah4, Mohammad Faheem5,  Rafiullah6

1FCPS (Cardiology) Resident, Department of Cardiology  Postgraduate Medical Institute Lady Reading Hospital Peshawar.
2Resident, Department of Cardiology, Postgraduate Medical Institute, Lady Reading Hospital Peshawar.
3FRCP, FCPS (Cardiology), FACC, SCAI Fellowship (USA) Professor, Head of Department and VC KMU, Department of Cardiology   Postgraduate Medical Institute, Lady Reading Hospital Peshawar.
4Resident, Department of Cardiology, Postgraduate Medical Institute, Lady Reading Hospital Peshawar.
5Senior registrar, Department of Cardiology, Postgraduate Medical Institute, Lady Reading Hospital Peshawar.
6Resident, Department of Cardiology, Postgraduate Medical Institute, Lady Reading Hospital Peshawar.

*Corresponding Author E-mail: cardiol2011@yahoo.com; Tel: 03339113365

Accepted 01 September, 2012

Abstract

To study the so-called risk factors associated with peripartum cardiomyopathy, its hospital course, short and long term mortality and outcome of subsequent pregnancies. A total of 61 patients diagnosed   with peripartum cardiomyopathy were enrolled in the study. Data regarding risk factors, presenting complaints, complications, pregnancy outcomes, therapeutics used and outcome at 3, 6 and 12 months were recorded. The incidence was estimated to be 1 per 933 deliveries. Mean age ±SD was 30.94±6.63 years. Majority of patients 33(54.1%) were obese. The mean parity was 3.66 ±1.41. Other risk factors were chronic hypertension 19 (31.1%), pre-eclampsia 12 (19.7%), multiple pregnancies 5(8.2%), long term tocolysis 13 (21.3%) and anemia 21(34.4%). Forty-three patients 43(70.5%) presented in post partum period while 18 (29.5%)    in atepartum period. Majority of patients presented with dyspnea and were in NYHA class ІІІ 18(29.5%) &IV 35(57.5%). Main ECG findings were sinus tachycardia 39 (63.9%), LV hypertrophy 42 (68.9%), T wave inversion 28(45.9%) and Poor R wave progression in precordial leads with Q waves 40(65.6%). Ejection fraction was universally reduced. Other echocardiograpic findings included chamber dilation 48(78.7%), moderate to severe mitral regurgitation 15(24.6%), left ventricular thrombus 12 (19.7%) and pulmonary artery hypertension 15(24.6%). Thirty-six women 36(59%) had normal vaginal delivery, 12(19.7%) had assisted vaginal delivery and 13(21.3%) required caesarean section. There were 50(82%) live births and 11(18%) perinatal deaths. The main complications were pulmonary edema 7(11.5%), cardiogenic shock 8(13.1%) and thromboembolism 13(21.3%). At hospital discharge, 9 (14.8%) patients were dead and 52(85.2%) were discharged with stable heart failure. Major therapeutics used was various drugs used in the treatment of heart failure and specialized therapies including implantable cardiac defibrillator (ICD) 5(8.2%)), cardiac resynchronization therapy (CRT) 3(4.9%)) and cardiac transplantation or left ventricular assist device 8(13.1%)). At the last follow up at month 12, total of   20(32.8%)) were dead while 32(52.5%)) had recovered fully and 9(14.75%)) were still suffering from heart failure. During follow up, only 8 (19.5) pregnancies were detected. Five 5(62.5) patients had uneventful course while two 3(37.5) developed heart failure again. Peripartum cardiomyopathy is associated with multiple risk factors and carries high morbidity and mortality.

Keywords: Peripartum cardiomyopathy, Risk factors, Hospital course, Prognosis.

Related Articles


Original Research Articles
El-Kersh TA, Marie MA, Al-Sheikh YA and Al-Kahtani SA
Prevalence and risk factors of community-acquired urinary tract infections due to ESBL-producing Gram negative bacteria in an Armed Forces Hospital in Sothern Saudi Arabia
Glo. Adv. Res. J. Pharm. Pharmacol. August 2015 Vol: 4(8): - [Abstract] [Full Text - PDF] (374 KB)
Bahar Sarıibrahim
Common predictive parameters anticipating pregnancy among poor and normoresponder patients in ICSI
Glo. Adv. Res. J. Pharm. Pharmacol. July 2017 Vol: 6(7): - [Abstract] [Full Text - PDF] (165 KB)
Saghatelyan AK, Revazyan RH, Ajabyan NA
Early Diagnosis of Ecosystem Pollution and Its Prognosis.
Glo. Adv. Res. J. Pharm. Pharmacol. July 2013 Vol: 2(7): - [Abstract] [Full Text - PDF] (235 KB)
Nisreen Haj, Mohamed Yousef, Elsafi Ahmed, Ikhlas Abdelaziz, Duha Abdu and Muna Ahmed
Assessment of Echocardiographic Imaging in Diagnosis of Heart Failure
Glo. Adv. Res. J. Pharm. Pharmacol. August 2017 Vol: 6(8): - [Abstract] [Full Text - PDF] (126 KB)
Yundong Zhang, Ibrahim El Bayoumy, Yihua Zhang, Huajiang Yang and Jiang Liu
Risk factors and predictors of early mortality after acute stroke: hospital based study
Glo. Adv. Res. J. Pharm. Pharmacol. June 2014 Vol: 3(6): - [Abstract] [Full Text - PDF] (102 KB)
Systematic Review
Masoud Mohammadnezhad, Nasser Salem Alqahtani, Mosese V Salusalu and Adam Konrote
Prevalence and determinant factors of overweight and obesity among Pacific people: A systematic review study
Glo. Adv. Res. J. Pharm. Pharmacol. June 2017 Vol: 6(6): - [Abstract] [Full Text - PDF] (198 KB)

Current Issue

Viewing Options

View Full Article - PDF
Download Full Article - PDF

Search for Articles

Ibrahim Shah on Google Scholar
Ibrahim Shah on Pubmed
Shahzeb on Google Scholar
Shahzeb on Pubmed
Mohammad Hafizullah on Google Scholar
Mohammad Hafizullah on Pubmed
Syed Tahir Shah on Google Scholar
Syed Tahir Shah on Pubmed
Mohammad Faheem on Google Scholar
Mohammad Faheem on Pubmed
Rafiullah on Google Scholar
Rafiullah on Pubmed

Statistics

Viewed 1450
Printed 562
Downloaded 1081
Powered By iPortal Works