The outcome of peripartum cardiac failure in Zaria, Nigeria.
We have studied 227 women who had peripartum cardiac failure (PPCF) in Zaria, Nigeria, since 1969-72.
This follow-up and review of survivors in 1993-95 depended chiefly on a Zaria woman (A. Abdullahi) and on her careful reporting.
Overall, 31 (13.7%) were completely lost to follow-up, 17 (7.5%) were thought to be alive, and there were data on 179 others (78.8%). Of the 75 known deaths, 55 were cardiovascular-20 due to PPCF, 31 due to cardiac failure unrelated to pregnancy (CF), and four were due to a cerebrovascular accident.
PPCF recurred in 13% of 551 subsequent pregnancies.
Thirty-two women had a recurrence of PPCF only, and 27 an episode of CF only.
Blood pressures rose steadily over the years.
An enlarged left ventricle on discharge after the index admission predicted a poor prognosis.
In 1993-5, we compared 100 survivors with 100 non-PPCF controls : 96 PPCF women but only 50 control women took extra salt (p=0.0001).
Significantly more PPCF women than controls had a diastolic pressure of 110mm Hg (p=0.011), The syndrome is probably provoked in potentially hypertensive women by the traditional practices of eating kanwa, which is rich in Na+taking additional excess salt and heating the body after delivery.
Evidence is presented that PPCF women are potentially hypertensive, and cannot handle the excess ingested sodium which therefore leads to hypervolaemia and thus PPCF.
Mots-clés Pascal : Insuffisance cardiaque, Association, Prépartum, Prévalence, Etude longitudinale, Facteur prédictif, Pronostic, Femelle, Homme, Nigéria, Afrique, Appareil circulatoire pathologie, Cardiopathie
Mots-clés Pascal anglais : Heart failure, Association, Prepartum, Prevalence, Follow up study, Predictive factor, Prognosis, Female, Human, Nigeria, Africa, Cardiovascular disease, Heart disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0137189
Code Inist : 002B12A01. Création : 21/07/1998.