A Prospective Cohort Study to Determine The Predictors of Peripartum Cardiomyopathy In Hypertensive Disorders of Pregnancy.

Abstract

BACKGROUND: Peripartum cardiomyopathy is one of the lately recognised causes of maternal mortality worldwide, but the exact cause of PPCM is still unknown. PPCM is often associated with many risk factors, especially hypertension in pregnancy, but its difficult to predict who among them will go for PPCM. So we wanted to study whether some of the markers which are raised in PPCM and hypertensive disorders of pregnancy can be used as predictors of PPCM. OBJECTIVE: To evaluate whether total leucocyte count, troponin i, serum prolactin levels in hypertensive disorders of pregnancy can be used as predictors of peripartum cardiomyopathy MATERIALS AND METHOD:A hospital based prospective cohort study was conducted among 265 study hypertensive patients . A blood sample was collected from pre eclampsia and eclampsia patients to see the level of biomarkers. These patients were further followed up up to 5 months postpartum to see whether they develop PPCM. RESULTS:A total of 265 hypertensive patients were studied. All patients were followed upto 5 months after delivery for clinical features of PPCM. A level of >0.64 +/- 0.2 of Troponin I was significantly associated with developing PPCM (p value = 0.04). Serum Prolactin level of >171.30+/- 72.07 (p value=0.007) was associated with PPCM similarly Total Leucocyte count >17166+/-9105.3 (p value = 0.05) was also significantly associated with developing PPCM in Hypertensive disorders of pregnancy CONCLUSION: From the present study we conclude that PPCM is common in young hypertensive pregnant patients and markers like Total leucocyte count, serum prolactin and Troponin I can be used for early diagnosis of the disease so as to prevent further complications