Pregnancy and peripartum cardiomyopathy. A comparative and prospective study.
OBJECTIVE
To assess pregnancy outcome in women with peripartum cardiomyopathy and to compare it with idiopathic cardiomyopathy.


METHODS
Twenty-six pregnant women, aged 28.4+/-6.1 years, with dilated cardiomyopathy were followed. Eighteen patients had peripartum cardiomyopathy [11 with persistent left ventricular systolic dysfunction (EF=45.2+/-2) and 7 with recovered ventricular function (EF=62.3+/-3.6)]. The 8 remaining patients had idiopathic cardiomyopathy (EF= 43.5+/-4.1). During the prenatal period, limited physical activity and a low-sodium diet were recommended, and hospitalization was recommended when complications occurred.


RESULTS
Of the 26 patients, 11 (42.3%) had a normal delivery; 9(35.5%) had cardiac complications, 6 (22.2%) had obstetric complications. Two patients (7.7%) died. Two preterm pregnancies occurred, with 26 health newborns (2 sets of twins). Two miscarriages took place. The cardiac complication rate during pregnancy was lower (p<0.009) in the peripartum cardiomyopathy group without ventricular dysfunction and greater (p=0.01) in the idiopathic group when compared with the peripartum group with ventricular dysfunction. Changes in left ventricular ejection fraction were not observed (p<0.05) in the postpartum period, when compared with that during pregnancy in the 3 groups.


CONCLUSIONS
Pregnancy in patients with dilated cardiomyopathy is associated with maternal morbidity. Left ventricular function is a prognostic factor and must be the most parameter when counseling patients with peripartum cardiomyopathy about a new pregnancy.
Avila
Walkiria Samuel
WS
Instituto do Coração do Hospital das Clínicas - FMUSP, São Paulo, Brazil. walkria@incor.usp.br
de Carvalho
Maria Elisa Carneiro
ME
Tschaen
Cleide K
CK
Rossi
Eduardo Giusti
EG
Grinberg
Max
M
Mady
Charles
C
Ramires
José Antonio Franchini
JA
D000293:Adolescent; D000328:Adult; D009202:Cardiomyopathies / Q000503:physiopathology*; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology*; D018566:Pregnancy, High-Risk; D011379:Prognosis; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D016277:Ventricular Function, Left