Key result
Symptoms of Peripartum Cardiomyopathy were debilitating and frightening for the 19 women interviewed, with onset during pregnancy for 17 women and a median time to diagnosis of 40 days.
Observational (n=19)
Women with peripartum cardiomyopathy experience debilitating physical and emotional symptoms that often start during pregnancy, with a median delay of 40 days to diagnosis, highlighting the need for improved symptom recognition by antenatal care providers.
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May support earlier PPCM symptom recognition in pregnancy; hypothesis-generating for strategies to reduce diagnostic delays.
OBJECTIVE: Peripartum Cardiomyopathy is a form of cardiac disease often associated with cardiac failure, occurring in late pregnancy or after childbirth. The anatomical and physiological changes in the mother associated with normal pregnancy are profound, and this may result in symptoms and signs that overlap with Peripartum Cardiomyopathy, leading to missed or delayed diagnosis. Women's experiences of Peripartum Cardiomyopathy symptoms remain poorly studied. The aim of this study was to explore and describe women's experiences of symptoms in Peripartum Cardiomyopathy. DESIGN: A triangulation of methods with individual interviews and data from medical records. SETTING: Mothers with Peripartum Cardiomyopathy diagnosis were recruited from Western Sweden as a part of research project. PARTICIPANTS: 19 women were interviewed and medical records were reviewed by authors. DATA ANALYSIS: All interview transcripts were analysed using qualitative inductive content analysis to identify key themes. RESULTS: The main theme, meaning of onset and occurrence of symptoms is captured in the metaphor: being caught in a spider web, comprising subthemes, invasion of the body by experienced symptoms and feeling of helplessness. Symptoms related to Peripartum Cardiomyopathy started for 17 women during pregnancy and in two post partum and time from symptoms to diagnosis varied between three and 190 days (median 40). The physical symptoms were:shortness of breath, excessive fatigue and swelling, bloatedness, nausea, palpitation, coughing, chest tightness, bodily pain, headache, fever, tremor, dizziness, syncope, restless and tingly body and reduced urine output. Emotional symptoms were: fear, anxiety, feelings of panic, and thoughts of impending death. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Symptoms of Peripartum Cardiomyopathy were debilitating, exhausting and frightening for the women interviewed in this study. Health care professionals responsible for the antenatal care, especially midwives, need skills to identify initial symptoms of Peripartum Cardiomyopathy for early referral and treatment by a specialist. In order to give optimal care more research is needed to show how to improve midwives' knowledge of Peripartum Cardiomyopathy.
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Patel et al. (2015) conducted an observational in Peripartum Cardiomyopathy (n=19). Peripartum Cardiomyopathy was evaluated on Women's experiences of symptoms in Peripartum Cardiomyopathy. Symptoms of Peripartum Cardiomyopathy were debilitating and frightening for the 19 women interviewed, with onset during pregnancy for 17 women and a median time to diagnosis of 40 days.
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