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. 2005 Aug;90(2):161-6.
doi: 10.1016/j.ijgo.2005.05.004.

Unrecognized peripartum cardiomyopathy in Haitian women

J D Fett  1 , L G Christie, R D Carraway, A A Ansari, J B Sundstrom, J G Murphy
Affiliations

Unrecognized peripartum cardiomyopathy in Haitian women

J D Fett et al. Int J Gynaecol Obstet. 2005 Aug.

Abstract

Objective: Haitian women have a high relative incidence of clinical presentation with peripartum cardiomyopathy (PPCM): an incidence estimated at one case per three hundred live births, a ten-fold occurrence compared to American women. Our objective has been to test the hypothesis that some Haitian women may have a forme fruste of PPCM while still without clinical symptoms.

Method: A preliminary case-control study was conducted at the Hospital Albert Schweitzer (HAS), Deschapelles, Haiti, in which 25 apparently healthy postpartum women, without cardiovascular symptoms and with a normal cardiovascular clinical examination, were selected from a consecutive list of obstetrical deliveries and screened by echocardiography for left ventricular dysfunction.

Result: Four out of 25 patients (16%) had asymptomatic left ventricular dysfunction that subsequently evolved towards either improvement or deterioration. Supporting evidence for the existence of asymptomatic left ventricular dysfunction or forme fruste PPCM is presented. A hypothetical schema of the pathophysiology of PPCM explains how a latent phase of variable duration may exist prior to onset of detectable clinical heart failure.

Conclusion: Screening Haitian women during the last month of pregnancy or in the early postpartum period may help to detect asymptomatic left ventricular dysfunction. Early detection and treatment of PPCM in a known high risk population could lead to improvements in maternal and fetal mortality and morbidity.

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