RISK FACTORS ASSOCIATED WITH PERIPARTUM CARDIOMYOPATHY
Keywords:(Peripartum Cardiomyopathy, (PPCM), Pregnancy, Cardiomyopathy, Congestive heart failure).
AbstractOBJECTIVE: To evaluate the variables implicated as risk factors in the development of peripartum
cardiomyopathy in our population.
SETTING: Thirty patients with peripartum cardiomyopathy admitted in Civil Hospital Karachi were
included in the study.
METHODS: A detailed relevant history especially regarding risk factors was taken from patient and after
that a detailed general physical and systemic examination was done.
Left ventricular functions were assessed using M. Mode targeted 2D ejection fraction, systolic and diastolic
segmental wall motion abnormalities were assessed by long and short axis views obtained at Parasternal,
subcostal and apical four and two chambers.
Patients having ejection fraction < 40%, Left ventricular end diastolic diameter (LVEDD) >55 mm and Left
ventricular end systolic diameter (LVESD) > 35mm were included in the study.
RESULTS: The mean age of the patients was 29.8 (range 19-45). Three patients (10%) had symptoms 1
month prepartum, 25 (83.3%) were presented within 2 month postpartum while 2 patients (6.6%) after 2
months of delivery. Ten patients (33.3%) were smoker, 4 (16.6%) were tobacco eater (but no one had taken
alcohol or cocaine), socio-economically all belonged to poor class,12 patients (40%) were malnourished, 6
(20%) patients were primipara, 8 (26.6%) patients were multipara and 16 (53.3%) patients were grand
multipara. Four (13.3%) patients had twin pregnancies, 5 (16.6%) patients had a history of toxaemia of
pregnancy, 2 (6.6%) had a history of long term tocolysis.
CONCLUSION: In our study the risk factors observed in greater frequency were age > 30 years, poor socioeconomic
class, malnutrition, smoking and tobacco eating, parity > 6, malnourishment, toxaemia of
pregnancy, long term tocolysis, blood group B+ve and twin pregnancies.