OBJECTIVE
To determine the incidence and prognosis of peripartum cardiomyopathy (PPCM) in rural
Haiti.
PATIENTS AND METHODS
Prospectively identified patients with PPCM treated at the Hospital Albert Schweitzer
(HAS), Deschapelles, Haiti, were included in this study. Patients who presented to
HAS from February 1, 2000, to January 31, 2005, were identified through a search of
the HAS PPCM Registry. Clinical and serial echocardiographic data were collected on
these patients.
RESULTS
The 5-year experience confirms the high incidence of PPCM in this area, approximately
1 case per 300 live births, which is severalfold the estimated incidence in the United
States (estimated 1 case per 3000 to 4000 live births). In this population, the ratio
of PPCM deaths for the 5-year period was 47.1 per 100,000 births compared with the
US ratio of 0.62 per 100,000 births. The mortality rate was 15.3% (15 deaths of 98
patients), and the mean follow-up was 2.2 years (range, 1 month to 5 years). Five
years after the initiation of the HAS PPCM Registry search, 26 (28%) of 92 patients
with PPCM observed for at least 6 months had regained normal left ventricular function.
The difference in left ventricular echocardiographic features at diagnosis between
deceased patients and survivors was not statistically significant: mean end-diastolic
dimension (6.2 vs 5.8 cm; P=.08), ejection fraction (22% vs 25%; P=.12), and fractional shortening (16% vs 15%; P=.46). Left ventricular echocardiographic features at diagnosis were unable to predict
individually who would eventually recover, although a statistically significant difference
occurred at diagnosis between the recovered group and nonrecovered group for mean
ejection fraction (28% vs 23%; P<.001) and fractional shortening (17% vs 14%; P=.004).
CONCLUSION
Peripartum cardiomyopathy occurs significantly more commonly in rural Haiti on a per
capita basis than in the United States. Patients with PPCM have a higher mortality
rate and a poorer return of normal ventricular function.
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Article Info
Footnotes
Funding from volunteer medical consultants and private contributions to humanitarian program of Hôpital Albert Schweitzer, Deschapelles, Haiti.
Identification
Copyright
© 2005 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
