It’s the greatest thing in the world – that moment you get to take your baby home and truly embrace the entirety of motherhood. But you’re sluggish and tired and, within a few months, you feel as though doing the simplest thing like changing your baby’s nappy or heating up a bottle leaves you breathless, weak and exhausted.
While many moms would just brush this off as mere exhaustion, it could be signs of a serious heart condition – peripartum cardiomyopathy (PPCM).
What is Peripartum Cardiomyopathy?
Peripartum cardiomyopathy is a type of heart failure which affects women who are about to give birth – one month before delivery – or who have had a baby in the past 6 months. It weakens the heart muscle and causes the heart to become enlarged. As a result, the heart cannot pump blood properly to the rest of the body.
Over the last decade there has been a steady increase in maternal mortality for cardiac disease in South Africa. We have found that, after non-pregnancy related infections, cardiac disease is the second most common cause of indirect maternal death, with peripartum cardiomyopathy and complications due to rheumatic heart disease contributing to more than 50% of cases.
What are the signs and symptoms of peripartum cardiomyopathy?
Signs of a failing heart include:
- shortness of breath at effort
- needing two to three pillows at night to sleep comfortably
- oedema of the legs (swollen legs)
- having noted that the heart is racing (palpitations)
If this condition is not recognised early and treated with several medications it may result in death.
Why do some women develop peripartum cardiomyopathy?
Novel data suggest a negative role of the hormone responsible for breastfeeding (prolactin) for women who have been diagnosed with peripartum cardiomyopathy. A very large international registry showed that patient presentations are similar globally.
What should you do when you feel short of breath before or after you’ve had a baby?
You need to see a nurse or doctor at a hospital or clinic nearby who will need to check if you have a heart problem or a lung problem.
What is the way forward?
Although findings from laboratory and clinical research in South Africa, centres in Europe, the US and other regions have helped us to understand what is causing this disease, further ongoing research is extremely important. Not only will this provide further understanding of this disease, it will also help us to manage this disease better and thereby improve the outcome of women with peripartum cardiomyopathy.
Written by: Prof. Karen Silwa-Hahnle, Hatter Institute for Cardiovascular Research In Africa