Peripartum Cardiomyopathy in India

Background Peripartum cardiomyopathy (PPCM) is characterized by left ventricular systolic dysfunction occurring toward the end of pregnancy or in the months following delivery. In India, delayed recognition due to overlap with physiological pregnancy symptoms often leads to advanced disease at presentation. This study aimed to evaluate the clinical profile, echocardiographic findings, management, and maternal-neonatal outcomes of PPCM cases managed at a tertiary care center. Methodology This retrospective observational study was conducted over three years in the Department of Obstetrics and Gynaecology at a tertiary care center. A total of 11 women fulfilling the European Society of Cardiology diagnostic criteria for PPCM were included. Demographic data, risk factors, clinical presentation, laboratory parameters, echocardiographic findings, management details, and maternal and neonatal outcomes were analyzed using descriptive statistics. Results The mean maternal age was 27.4 ± 6.1 years. Most patients were unbooked referrals (90.9%), and 54.5% presented in the antepartum period. Breathlessness was the predominant symptom (90.9%), with 90.9% presenting in New York Heart Association class III-IV. Preeclampsia was the most common associated risk factor (54.5%). Mean left ventricular ejection fraction (LVEF) at diagnosis was 35.3% (range = 15-45%). Severe left ventricular dysfunction (<30%) was observed in half of the cases. Intensive care unit admission was required in the majority, with mechanical ventilation in 27.3% and cardiogenic shock in 33.3%. Maternal mortality was 9.1%. At six months, 80% of survivors demonstrated recovery of left ventricular function (LVEF >50%), while 20% had persistent dysfunction. Preterm birth occurred in 44.4% of deliveries. Neonatal mortality was 11.1%, and neonatal intensive care unit admission was required in 22.2%. Conclusions PPCM remains an under-recognized yet potentially life-threatening cause of heart failure in pregnancy. Most patients present with severe left ventricular dysfunction but demonstrate significant recovery with timely multidisciplinary management. Increased clinical awareness, early diagnosis, and structured follow-up are essential to improve maternal and neonatal outcomes.