Peripartum cardiomyopathy

Melita Moioli, Mario Valenzano Menada, Giorgio Bentivoglio, Simone Ferrero

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

According to current deWnition, peripartum cardiomyopathy (PPCM) is a rare disorder in which left ventricular dysfunction and symptoms of heart failure occur in the last month of pregnancy. It has been reported that the incidence of PPCM is 1 in 3,000-4,000 live births. The pathogenesis is poorly understood, however, infectious, immunologic, and nutritional causes have been hypothesized. Clinical presentation includes usual signs and symptoms of heart failure, and unusual presentations such as thromboembolism. Diagnosis is based upon the clinical presentation of congestive heart failure and the objective evidence of left ventricular systolic dysfunction. Early diagnosis and initiation of treatment are essential to optimize pregnancy outcome. Patients with systolic dysfunction during pregnancy are treated similar to patients who are not pregnant. The mainstays of medical therapy are digoxin, loop diuretics, sodium restriction and afterload reducing agents (hydralazine and nitrates). Due to a high risk for venous and arterial thrombosis, anticoagulation with subcutaneous heparin should be instituted. Angiotensin- converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy because of severe adverse neonatal effects. Effective treatment reduces mortality rates and increases the number of women who fully recover left ventricular systolic function. The prognosis is poor in patients with persistent cardiomyopathy. Subsequent pregnancies are often associated with recurrence of left ventricular systolic dysfunction.

Original languageEnglish
Pages (from-to)183-188
Number of pages6
JournalArchives of Gynecology and Obstetrics
Volume281
Issue number2
DOIs
Publication statusPublished - Feb 2010

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Peripartum Period
Cardiomyopathies
Left Ventricular Dysfunction
Pregnancy
Heart Failure
Sodium Potassium Chloride Symporter Inhibitors
Hydralazine
Angiotensin Receptor Antagonists
Thromboembolism
Digoxin
Reducing Agents
Live Birth
Pregnancy Outcome
Left Ventricular Function
Angiotensin-Converting Enzyme Inhibitors
Venous Thrombosis
Nitrates
Signs and Symptoms
Heparin
Early Diagnosis

Keywords

  • Heart failure
  • Peripartum cardiomyopathy
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Peripartum cardiomyopathy. / Moioli, Melita; Menada, Mario Valenzano; Bentivoglio, Giorgio; Ferrero, Simone.

In: Archives of Gynecology and Obstetrics, Vol. 281, No. 2, 02.2010, p. 183-188.

Research output: Contribution to journalArticle

Moioli, M, Menada, MV, Bentivoglio, G & Ferrero, S 2010, 'Peripartum cardiomyopathy', Archives of Gynecology and Obstetrics, vol. 281, no. 2, pp. 183-188. https://doi.org/10.1007/s00404-009-1170-5
Moioli, Melita ; Menada, Mario Valenzano ; Bentivoglio, Giorgio ; Ferrero, Simone. / Peripartum cardiomyopathy. In: Archives of Gynecology and Obstetrics. 2010 ; Vol. 281, No. 2. pp. 183-188.
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