title: Pregnancy and peripartum cardiomyopathy. A comparative and prospective study.
abstract: 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.
authors.affiliation: Instituto do Coração do Hospital das Clínicas - FMUSP, São Paulo, Brazil. walkria@incor.usp.br
authors.forename: Walkiria Samuel
authors.initials: WS
authors.lastname: Avila
authors.forename: Maria Elisa Carneiro
authors.initials: ME
authors.lastname: de Carvalho
authors.forename: Cleide K
authors.initials: CK
authors.lastname: Tschaen
authors.forename: Eduardo Giusti
authors.initials: EG
authors.lastname: Rossi
authors.forename: Max
authors.initials: M
authors.lastname: Grinberg
authors.forename: Charles
authors.initials: C
authors.lastname: Mady
authors.forename: José Antonio Franchini
authors.initials: JA
authors.lastname: Ramires
mesh_terms: 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