Figure 1
A linear graph demonstrating the incidence of PPCM in Oman in the period from.
Table 1
Demographic data and pregnancy details.
| VARIABLES | OUTCOME OF 116 CASES |
|---|---|
| Institution, n (%) | |
| RH | 98 (84.5%) |
| SQUH | 18 (15.5%) |
| Region n (%) | |
| Muscat | 56 (48.3%) |
| South Al-Batinah | 13 (11.2%) |
| North Al-Batinah | 9 (7.8%) |
| Al-Sharqiyah | 15 (12.9%) |
| Musandam | 3 (2.6%) |
| Buraimi | 3 (2.6%) |
| Dhufar | 1 (0.9%) |
| Al-Dhahira | 1 (0.9%) |
| Al-Dakhiliya | 15 (12.9%) |
| Family history of PPCM | 2 (1.7%) |
| Maternal age (years), n (%) | |
| 20–25 years | 14 (12.1%) |
| 26–30 years | 32 (27.6%) |
| 31–35 years | 37 (31.9%) |
| 36–40 years | 28 (24.1%) |
| >40 years | 5 (4.3%) |
| Parity, n (%) | |
| One birth | 53 (45.7%) |
| Two or three births | 12 (10.3%) |
| Four or more births | 51 (44.0%) |
| Antenatal booking status, n (%) | |
| Booked | 38 (32.8%) |
| Un booked | 78 (67.2%) |
| Number of fetuses, n (%) | |
| Singleton | 83 (71.6%) |
| Multiple pregnancies | 10 (8.6%) |
| Missing | 23 (19.8%) |
| Gestational age at diagnosis, n (%) | |
| Third trimester | 28 (24.1%) |
| Intrapartum | 2 (1.7%) |
| Postpartum | 76 (65.5%) |
| Missing | 10 (8.6%) |
[i] SQUH: Sultan Qaboos University Hospital, RH: Royal Hospital, PPCM: Peripartum Cardiomyopathy. * Unbooked: pregnant women who did not follow during pregnancy at SQUH or RH.
Table 2
Antenatal comorbidities.
| ANTENATAL COMORBIDITIES | OUTCOMES N (%) |
|---|---|
| Diabetes in pregnancy: | |
| Gestational diabetes | 12 (10.3%) |
| Pre-existing diabetes | 7 (6.0%) |
| Hypertensive disorders of pregnancy: | |
| Gestational hypertension/pre-eclampsia | 25 (21.6%) |
| Chronic hypertension | 9 (7.8%) |
| Hematological diseases: | |
| Sickle cell disease | 4 (3.4%) |
| Thalassemia major | 2 (1.7%) |
| Asthma | 7 (6.0%) |
| Hepatitis B | 2 (1.7%) |
| Congenital heart disease | 1 (0.9%) |
Table 3
Clinical Characteristics.
| CLINICAL CHARACTERISTICS PRESENTED AS N (%), UNLESS EXPRESSED OTHERWISE | OUTCOMES (N = 116) |
|---|---|
| Presenting symptoms, n (%) | |
| Shortness of breath | 71 (61.2%) |
| Exertional dyspnea | 45 (38.8%) |
| Palpitation | 20 (17.2%) |
| Orthopnea | 19 (16.4%) |
| Chest pain | 15 (13.5%) |
| Cough | 15 (12.9%) |
| Paroxysmal nocturnal dyspnea | 9 (7.8%) |
| Sweating | 4 (3.4%) |
| Fever | 3 (2.6%) |
| Cardiac arrest during labor | 3 (2.6%) |
| Signs, n (%) | |
| Tachycardia | 9 (7.8%) |
| Bradycardia | 2 (1.7%) |
| Hypotension | 1 (0.9%) |
| NYHA classification | |
| Class I | 34 (29.3%) |
| Class II | 53 (45.7%) |
| Class III | 14 (12.1%) |
| Class IV | 15 (12.9%) |
| Electrocardiography, n (%) (n=32) | |
| Sinus tachycardia | 10 (33.3%) |
| Supraventricular tachycardia | 0 (0.0%) |
| ST depression | 1 (3.2%) |
| WPW syndrome | 1 (3.3%) |
| Left ventricular hypertrophy changes | 3 (9.4%) |
| Chest X-ray, n (%) | |
| Cardiomegaly | 16 (17.2%) |
| Pulmonary congestion | 10 (11.0%) |
| Obliterated costophrenic angles | 3 (3.2%) |
| Pleural effusion | 6 (6.7%) |
| Troponin Value (pg/mL), median (IQR) (n = 22) | 11.5 (0.04–37.25) |
| BNP Value (pg/mL), median (IQR) (n = 9) | 2420.00 (373.00–6132) |
Table 4
Echocardiography Changes.
| MEAN% (RANGE, ± SD) | MISSING | |
|---|---|---|
| LVEF 1 | 33.25% (15–45, ± 7.72) | 8 |
| LVEF 2 | 43.3% (20–65, ±12.32) | 64 |
| LVEF 3 | 45.83% (15–62, ± 12.50) | 13 |
[i] LVEF 1: Left ventricular ejection fraction at the time of diagnosis.
LVEF 2: Left ventricular ejection fraction at 6 months post diagnosis.
LVEF 3: Left ventricular ejection fraction at 18 months post diagnosis.
Table 5
Perinatal Outcomes.
| PERINATAL VARIABLESPRESENTED AS N (%), UNLESS EXPRESSED OTHERWISE | PERINATAL OUTCOME (N = 73) |
|---|---|
| Mode of delivery, n (%) for 73 women | |
| Spontaneous vaginal delivery | 21 (28.8%) |
| Instrumental vaginal delivery | 2 (2.7%) |
| Cesarean section | 50 (68.5%) |
| Intensive care unit admission, n (%) | 23 (31.9%) |
| Duration of hospital stay, n (%) (n = 35) | |
| <7 days | 19 (54.3%) |
| 7–14 days | 13 (37.1%) |
| 15–28 days | 1 (2.9%) |
| 29–32 days | 2 (5.7%) |
| Complications, n (%) | |
| Pulmonary edema | 15 (16.3%) |
| Infection | 7 (7.1%) |
| Thromboembolism | 2 (2.0%) |
| Fully recovered, n (%) | 61 (56.0%) |
| Recurrence, n (%) | 8 (9.2%) |
| Mortality, n (%) | 4 (3.4%) |
| Gestational age at delivery, n (%) | |
| 28 to 33+6 weeks | 6 (8.2%) |
| 34 to 37+6 weeks | 14 (19.2%) |
| >37+6 weeks | 53 (72.6%) |
| NEONATAL OUTCOMES (N = 51) | |
| Gender, n (%) | |
| Male | 24 (47.1%) |
| Female | 27 (52.9%) |
| Apgar score at 5 minutes, n (%) | |
| 0–6 | 4 (8.5%) |
| 7 or higher | 43 (91.5%) |
| Missing | 4 |
| NICU admission n (%) | 9 (17.6%) |
| Live birth, n (%) | 49 (94.3%) |
| Stillbirth, n (%) | 2 (4.3%) |
| Birth weight (mean, range ± SD) | |
| Male | 3.00, (1.80-4.70) ± 0.79 |
| Female | 2.76 (1.12-4.4) ± 0.85 |