Peripartum cardiomyopathy

Objective: To determine the clinical and echocardiographic profiles of women with peripartum cardiomyopathy and ascertain the natural course of the disease. Methods: Fifty-six women with peripartum cardiomyopathy were followed up for a mean period of 6.1 years and their clinical and echocardiographic profiles were studied as well as their outcomes. Results: The mean +/- SD age at presentation was 31 +/- 5 years and mean parity was 2.6 +/- 1. Of the 56 patients, 18 (32.1%) had NYHA Class II, 24 (42.9%) had NYHA Class III, and 14 (25%) had NYHA Class IV symptoms, and 21 (37.5%) and 35 (62.5%), respectively, presented with features of heart failure during pregnancy and the postpartum. During follow-up, the left ventricutar ejection fraction improved from 31% +/- 7.2% to 43% +/- 8% (P <= 0.05). Nine patients (16.1%) became pregnant, with a mortality of 55.5% during pregnancy and 23.2% during follow-up. Conclusion: Women with peripartum cardiomyopathy present with severe left ventricutar dysfunction late in the pregnancy or early in the puerperium. A considerable number of women still die from this condition despite the use of angiotensin-converting enzyme inhibitors and beta-blockers. A subsequent pregnancy carries a very high risk of mortality. (c) 2006 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.