Peripartum cardiomyopathy: A review of prevalence and treatment trends from an African perspective

Kedir Negesso Tukeni^1,2*Tamirat Godebo Woyimo¹Elsah Asefa¹Esayas Kebede Gudina¹Heidi Estner²Nikolaus Haas²

• ¹Department of Internal Medicine, Jimma University, Jimma, Ethiopia
• ²Ludwig Maximilian University of Munich, Munich, Bavaria, Germany

Peripartum cardiomyopathy (PPCM) is a type of dilated cardiomyopathy that develops in women without a history of heart disease during the last trimester of pregnancy or within six months following delivery. It is one of the primary causes of heart failure during pregnancy, which increases peripartum morbidity and mortality. The condition can cause significant left ventricular dysfunction, progressive heart failure, and refractory cardiogenic shock, resulting in increased maternal morbidity and mortality. Dyspnea, exhaustion, and lower extremity edema are common symptoms and signs that are frequently misdiagnosed as normal postpartum changes, demanding careful assessment with echocardiography. Furthermore, it is often diagnosed and treated late due to insufficient awareness among healthcare providers, with varying definitions of the disease across countries. Its underlying causes remain unclear, though recent studies point to a potential prolactin-oxidative stress mechanism that might lead to potential future treatments. Clinical care follows basic heart failure management guidelines while taking medication teratogenicity into account. The prognosis varies geographically based on the level and pattern of treatment, with a considerable number of patients displaying partial recovery. The prevalence and treatment patterns of these patients in Africa, including the benefits and safety profiles of bromocriptine, are reviewed here, to identify directions in its prospective use in different forms of cardiomyopathies based on the available literature.