title: Pregnancy with dilated and peripartum cardiomyopathy: maternal and fetal outcome.
abstract: BACKGROUND
  A retrospective review of the records of all the patients of dilated cardiomyopathy (DCM) with pregnancy at PGIMER, Chandigarh, India, in order to find out maternal and fetal outcome.
  
  
  METHODS
  We did a retrospective analysis of records of diagnosed cases of DCM from 1994 to 2010. There were records of 38 patients who had DCM with pregnancy. Detailed history was followed by systemic examination, routine investigations and echocardiography. Multidisciplinary care was given to these women by obstetrician, cardiologist, anesthetist and neonatologist. Pharmacotherapy consisted to diuretics, alpha and beta blockers and heparin or low-dose aspirin for thrombo prophylaxis. Elective induction of labor was advised after 37 weeks of gestation subject to favorability of cervix.
  
  
  RESULTS
  Out of 1,472 patients of heart disease during study period, 38 women had DCM. Out of these, 8 (21 %) had idiopathic cardiomyopathy, two had DCM due to thyrotoxicosis and 28 (73.6 %) patients had peripartum cardiomyopathy. Mean gestational age at the time of presentation was 35 weeks. Majority of the patients (19/38) presented with complaints of exertional dyspnoea. Mean LVEF at the time of diagnosis was 32.28 %. There were six (15.8 %) maternal deaths and all of them had global hypokinesia on echocardiography and presented in NYHA class IV. Fetal outcome too depended upon maternal cardiac status. There were eight stillbirths and all the patients who had IUFD belonged to class IV. Twelve patients (40 %) had preterm delivery. Mean birth weight of babies was 2 kg.
authors.affiliation: Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Vanita
authors.initials: V
authors.lastname: Suri
authors.forename: Neelam
authors.initials: N
authors.lastname: Aggarwal
authors.forename: Arun
authors.initials: A
authors.lastname: Kalpdev
authors.forename: Seema
authors.initials: S
authors.lastname: Chopra
authors.forename: Pooja
authors.initials: P
authors.lastname: Sikka
authors.forename: Rajesh
authors.initials: R
authors.lastname: Vijayvergia
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D003131:Combined Modality Therapy; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D004232:Diuretics; D005343:Fibrinolytic Agents