A Clinical Study on Peripartum Cardiomyopathy at Tertiary Care Centre

Background: Cardiac disease complicating pregnancy is of importance since ages. Maternal death attributable to cardiovascular diseases occupies significant place among developed and in developing countries. In India, cardiac disease complicates 2 % of all pregnancies and contributes to one - fifth of all maternal deaths 1. Peripartum Cardiomyopathy (PPCM) is a unique form of nonischemic dilated cardiomyopathy of unknown etiology- defined as cardiac failure in the last month of pregnancy or within 5 months after delivery. Aim of this study is to determine the age group, period of presentation (antenatal / postpartum), mode of presentation, associated comorbidities, maternal outcome of PPCM. Methods: This study is a prospective observational study conducted on antenatal, postpartum patients admitted in the Department of Obstetrics and Gynaecology, GRMH attached to Government Thanjavur Medical College over a period of 18 months from January 2021 to August 2022. Women who were not a known heart disease till the date of admission were observed for a period of 18 months and the one with newly established heart disease in their peripatum period were picked up and analysed. Results: A total of 28 cases of PPCM are noted in the study. The incidence of PPCM found to be 0.093 % among the total mothers admitted over a period of eighteen months. The maximum number of patients are in the age group of 20- 25 years (12 /28patients). 10 out of 28 patients presented in their antenatal period, 18 patients presented postpartum. 6 patients had associated anemia, 8 pateints had associated severe preeclampsia, 2 patients had associated gestational hypertension, 14 were in ionotropic supports in this study, 2 cases had history of PPCM in previous pregnancies. Among the 28 cases, 4 maternal deaths were reported. Conclusion: Careful assessment of risk factors, eliciting detailed history about any prior cardiac events and followup ECHOs in previous history of PPCM, careful monitoring of patients with risk factors for ppcm could help us to anticipate and early diagnosis. These patients needs highrisk antenatal care in future pregnancies.