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severe enough , that the y alone, could easily have bee n blamed
for t h e heart failure. They ther.efore suggested t hat h yp e r ­
tension must play ;:" role in t he pat hogenesis of t he disease
[ 195 J . The I b a d a n s tudy [ 195], h owe v e r was d on e muc h earlier
than the Zaria study, a nd the researchers probably had not
suspected any t r ad i t i on a l postpartum practices as possible
contributory factors . Their study population, it s hou l d be
n oted, also consisted of Yct-ubav e who are a d i f ferent e t hnic
group with different traditions from the rla usas in northern
Nigeria ( 19 5 ] .
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Long -term ec uddes , in patients who develop pe r i-part um
c ard i a c failure , have shown a relatively poor progn os is
f I9S ,2I9 ]. Between 24 t o 45% o f SUbjects have been observed to
de velop chroni c hypertension [ 195 , 219). A high mortality r a t e
of 11% wi thin t h e f irst year of disease was noted in Zaria
[2 19] . Heart failure , unrelated to pregnancy, later occ urred
in 13% o f SUbjects and 9% of affected c ases deve loped dilated
cardiomyopathY [219 ] . A r ec ur r e nce of the cond i tion with
SUbsequent pregnancies a lso oc c urs (194 , 195 , 219 ) . In t he
zari a a nd I bada n studies for example, 26 % and 22 :t resp ectively
o f the study SUb j e c t s de ve l oped the cond i t i on with subsequent
pregnancies [ 194 , 195 ] . About fifty percent of c ases however
have been coservea t o recover without further episodes [ 219) .
With the exception of tnese detailed Nigerian studies,
there i s little reported about the disorder in other parts of