Independent predictors of mortality in peripartum cardiomyopathy: Casablanca university hospital

Abstract

Introduction

Peripartum cardiomyopathy (PPCM) is a rare, unrecognized and a life-threatening pregnancy-associated disease. It is established as left ventricular dysfunction occurring in the last month of pregnancy or the first 5 months postpartum in the absence of known aetiology or preexisting heart disease. More than half of affected women recover systolic function, although a minority requires mechanical support or cardiac transplantation (or both). We have conducted a five-year retrospective study to determine independent predictors of mortality in meadows cardiomyopathy.

Method

We retrospectively reviewed all the patients admitted for suspected PPCM in obstetric gynecology, cardiology or intensive care department from January 2017 to December 2022.

Results

A total of 88 patients were included in this study, all the patients were followed for at least 12 months after diagnosis. The mean age of our patients was 29 ± 5 years. The diagnosis was established antepartum in 24%, postpartum in 48% and 26% at the start of labor. The mean age of pregnancy at diagnosis was 34 ± 6 weeks of amenorrhea. Mean parity was 2.2 ± 1.8 and mean gravidity was 2.4 ± 1.6. Dyspnea and left heart failure symptoms were the most frequent signs of PPCM observed in our patients with respectively 92% and 41% for each. Mortality rate was 11.5% in our population, and were associated significantly with the absence of pregnancy follow-up (P < 0.01), preeclampsia (P = 0.045), altered left ejection fraction LVEF < 30% (P = 0.029) and severe mitral regurgitation (P = 0.036).

Conclusion

PPCM is a rare and potentially life-threatening heart disease with a significant maternal morbidity and mortality rate. Early diagnosis based on transthoracic echocardiography is essential and appropriate medical therapy should be started rapidly (Table 1).