title: Peripartum cardiomyopathy - case series.
abstract: OBJECTIVE
  To study the pattern of presentation, course of disease and outcome of pregnancy in Peripartum Cardiomyopathy.
  
  
  METHODS
  A prospective study of sixteen cases of PPCM was conducted at Apple Saraswati Multispecialty Hospital and Dr. D.Y. Patil Medical College and Hospital, Kolhapur, Maharashtra, India from January 2006 to December 2012. Data included age distribution, parity, gestational age, symptoms and risk factors. Medical management and pregnancy outcome were documented. Serial echocardiography data was compiled for a period of one year.
  
  
  RESULTS
  In our study 9/16 (56%) were primigravidae, 4/16 (25%) had pre-eclamsia and 6/16 (35%) had co-existing hypertension. The difference in Echocardiography parameters observed between recovered and non-recovered patients was significant: Left Ventricular End diastolic dimension (5.6 cm vs 6.06 cm), Left Ventricular Ejection Fraction (28.7% vs 22.4%) and Left Ventricular fractional shortening (17.5% vs 13.4%). Thirteen out of sixteen patients were followed up for a period of one year out of which 61% (8/13) patients recovered completely. There was one mortality.
  
  
  CONCLUSIONS
  PPCM is a diagnosis of exclusion. Majority were young primigravidae presenting postnatally. Pre-eclampsia and hypertension were risk factors. ECHO parameters were reliable predictors of recovery. Future pregnancies are better avoided.
authors.affiliation: Associate Professor, Dept. of OBGyn, Dr. D.Y. Patil Hospital, Kolhapur, Maharashtra 416006, India. Electronic address: sayi_prasad@rediffmail.com.
authors.forename: Gowri Sayi
authors.initials: GS
authors.lastname: Prasad
authors.affiliation: Chief Cardiologist, Dept. of Cardiology, Apple Saraswati Multispeciality Hospital, Kolhapur, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Bhupali
authors.affiliation: Chief Intensivist, Dept. of Intensive Care, Apple Saraswati Multispeciality Hospital, Kolhapur, India.
authors.forename: Sayi
authors.initials: S
authors.lastname: Prasad
authors.affiliation: Head of Department, Dept. of OBGyn, Dr. D.Y. Patil Hospital, Kolhapur, India.
authors.forename: Ajit N
authors.initials: AN
authors.lastname: Patil
authors.affiliation: Post-Graduate Student, Dept. of OBGyn, Dr. D.Y. Patil Hospital, Kolhapur, India.
authors.forename: Yashodhan
authors.initials: Y
authors.lastname: Deka
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D006801:Humans; D007194:India; D010298:Parity; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D011256:Pregnancy Outcome; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: 2D ECHO; Cardiomyopathy; Heart failure; Peripartum; Pregnancy