MATERNITY AND MYOCARDIAL FAILURE IN AFRICAN WOMEN

Publisher Website
Google Scholar
Abstract
For the first time in Africa, peri-partum myocardial failure is described. The follow-up here reported comprises 23 episodes in 22 African women in Johannesburg. The time relations of the onset of failure and maternity, specifically in the last trimester of pregnancy and in the post-partum period, are established. The condition is seen to be by far the commonest type of idiopathic myocardial failure in Johannesburg in African women before the menopause. A significant relationship is shown between incidence on the one hand and high parity, high childbearing age, and twinning on the other. An unfavorable prognosis is significantly related to high age and parity; long-continued lactation after presentation and subsequent pregnancies are also seen to have adverse effects. Early onset followed by prompt medical attention is associated with a favorable outcome. The cases are placed in three groups according to the pressence or absence of ventricular hypertrophy and the persistence of an enlarged heart. These groupings have a relationship to prognosis. The definition of the syndrome is discussed, and previous reports are reviewed. Similarities and divergencies are noted between our series and earlier ones, and also between our series and other idiopathic cardio-myopathies among Africans. Alternative hypotheses as to etiology are formulated.