Prevalence and outcome of peripartum cardiomyopathy in Malaysia.

INTRODUCTION

Peripartum cardiomyopathy (PPCM) is an uncommon form of congestive heart failure, afflicting obstetric patients around the time of delivery. The epidemiology of PPCM is infrequently reported. To the best of our knowledge, there has been no report from Asia.

OBJECTIVE

To define the prevalence, presentation and outcome of PPCM in a major referral centre in Malaysia.

METHODOLOGY: Retrospective case record analysis of all patients admitted and diagnosed with PPCM at the University Malaya Medical Centre, Kuala Lumpur, over 5 years from 1st January, 2001 to 31st December, 2004.

RESULTS

Eight patients were diagnosed with PPCM over the study period reflecting a prevalence of 34: 100,000 life births. Five were diagnosed within 5 months after delivery. Three were associated with twin pregnancies. There was one death (12.5% mortality). The mean left ventricular ejection fraction (LVEF) at the time of diagnosis was 27.1 +/- SD 6.4% (range: 17-35%). Following the index event, the left ventricular function recovered in three of the eight patients (37.5%) with restoration of normal LVEF (LVEF > 50%). Two patients had subsequent pregnancies. One was terminated at 7 weeks, and the other delivered uneventfully with a normal LVEF.

CONCLUSIONS

Peripartum cardiomyopathy is uncommon in Malaysia. It appears to be associated with twin pregnancy. The outcome is variable with 37.5% recovering normal left ventricular function, 12.5% mortality and persistently impaired left ventricular function in the remainder.