Risk Factors of Peripartum Cardiomyopathy and the Important Role of Prenatal Care

Hawani Sasmaya Prameswari^1, , Augustine Purnomowati¹ and Toni Mustahsani Aprami¹

¹Department of Cardiology and Vascular Medicine, Padjadjaran University, Jalan Eijkman 38, Bandung 40161, Indonesia

Cite this paper:
Hawani Sasmaya Prameswari, Augustine Purnomowati and Toni Mustahsani Aprami. Risk Factors of Peripartum Cardiomyopathy and the Important Role of Prenatal Care. American Journal of Cardiovascular Disease Research. 2015; 3(1):5-8. doi: 10.12691/ajcdr-3-1-2

Abstract

Peripartum cardiomyopathy (PPCM) is one of dilated cardiomyopathy of unknown cause. The aim of this study is to determine the risk factors and the importance of prenatal care (PNC). This is a descriptive and analytical study with Chi Square test of PPCM cases collected from medical records January 1, 2011 through December 31, 2013 in the Dr.Hasan Sadikin Central General Hospital as the top-referral hospital of West Java Province. We collected 57 PPCM cases (18.7%) of 305 pregnant women or 6 months postpartum with cardiovascular problems. Distribution of PPCM cases decreased significantly (p= 0.002) from 2011 (27 patients), 2012 (16 patients), and 2013 (14 patients), with average age 30.3 (±7.9) years, cesarean delivery (43.8%), pervaginal (37.5%), forceps (15%), and vacuum-extractor (3.8%). Regular prenatal care was 84.20%. Lower socioeconomic patients were 63.2%, therefore the issue of welfare can lead to vulnerability to PPCM. Confirmed diagnosis using echography made during postpartum was 52.63% and antepartum was 47.5%. Preeclampsia was 43.80% (p=0.007) mostly NYHA functional class IV (86.30%). Echocardiography was performed on 57 patients have average ejection fraction 34.8%, global hypokinetic in 98.27% patients, 39.6% with all cardiac chamber dilatation, left atrium and left ventricle dilation in 34.48%, and 25.86% with left ventricular dilatation. The hospital based prevalence was 18.68%, with the majority (84.20%) was NYHA functional class IV. The significant risk factors were age over 30 years, multiparous, low socioeconomic, and preeclampsia. This study is probably the first report mentioning a high prevalence of PPCM in Indonesia. This report provides an awareness of PPCM during PNC to prevent the morbidity and mortality. PPCM disorder requires regular and careful PNC by taking into account existing risk factors is the key that is required and must be held in every health centre.

Keywords:
peripartum cardiomyopathy risk factor prenatal care pregnant woman

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