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Peripartum cardiomyopathy – risk factors, characteristics and long-term follow-up

  • Hagit Shani , Rafael Kuperstein , Alla Berlin , Michael Arad , Ilan Goldenberg und Michal J. Simchen EMAIL logo
Veröffentlicht/Copyright: 30. Mai 2014
Journal of Perinatal Medicine
Aus der Zeitschrift Journal of Perinatal Medicine Band 43 Heft 1

Abstract

Aims: Peripartum cardiomyopathy (PPCM) is an infrequent form of cardiomyopathy causing significant maternal morbidity and mortality. We aimed to evaluate the risk factors, characteristics and prognosis of PPCM during the index and subsequent pregnancies.

Methods: A retrospective cohort of 36 women with PPCM in a tertiary medical center was analyzed and compared with 10,370 women who gave birth during a single calendar year at the same institution.

Results: Women diagnosed with PPCM were older (mean 33.5 years) than controls. A significantly higher proportion were primiparous (63.9%), carried multifetal pregnancies (33.3%) and had hypertensive pregnancy complications (38.9%). Thirty-six percent of PPCM patients conceived with in vitro fertilization, and six of them received ovum donation. Twenty-two women had severe left ventricular dysfunction at diagnosis, and these women tended to remain with residual disease, compared with women with milder ventricular dysfunction at diagnosis. Eight patients recovered completely within 2 weeks of diagnosis. Women who recovered early (n=8) had significantly higher ejection fractions on last follow-up compared with women (n=28) who had late or partial recovery. Nine women had 14 additional pregnancies; of them eight women had normal cardiac functions on subsequent pregnancy.

Conclusions: Risk factors for peripartum cardiomyopathy include primiparity, hypertension and multifetal pregnancies. Assisted reproduction techniques are not independently associated with PPCM but rather through other risk factors for PPCM. The degree of cardiac dysfunction at diagnosis and time to recovery are important prognostic factors.

Keywords: Assisted reproduction technique; peripartum cardiomyopathy; pregnancy and postpartum
Corresponding author: Michal J. Simchen, MD, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Ramat Gan, 52621, Israel, Tel.: + 972-3-5302169, Fax: + 972-3-5302922, E-mail:
aReprint requests should be sent to: Hagit Shani, MD, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Ramat Gan, 52621, Israel, Tel.: + 972-3-5302169, Fax: + 972-3-5302922, E-mail: Hagit.Shani@sheba.health.gov.il

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2014-3-9
Accepted: 2014-5-5
Published Online: 2014-5-30
Published in Print: 2015-1-1

©2015 by De Gruyter

Artikel in diesem Heft

  1. Frontmatter
  2. Academy’s Corner
  3. Maternal mortality: an ongoing challenge to perinatal medicine
  4. Fetal mild ventriculomegaly: still a challenging problem
  5. Review article
  6. Natural killer cell in the developing life
  7. Original articles – Obstetrics
  8. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques
  9. Individual consultant practice does not affect the overall intervention rate: a 6-year study
  10. Identifying high-risk subgroups for alcohol consumption among younger and older pregnant women
  11. Ultrasonographic severity scoring of non-immune hydrops: a predictor of perinatal mortality
  12. Controversial clinical practices for patients with preeclampsia or HELLP syndrome: a survey
  13. Inter- and intra-observer variability in cervical measurement by ultrasound in the first and second trimesters of pregnancy: does it matter?
  14. Personnel-itis: a myth or a pathology? A retrospective analysis of obstetrical and perinatal outcomes for physicians and nurses
  15. Placenta-secreted circulating markers in pregnant women with obstructive sleep apnea
  16. Variations of blood cells in prediction of gestational diabetes mellitus
  17. Peripartum cardiomyopathy – risk factors, characteristics and long-term follow-up
  18. Original article – Fetus
  19. Effect of assisted reproductive technology on fetal brain development assessed by prenatal ultrasonography
  20. Original article – Newborn
  21. Racial/ethnic differences in the birth prevalence of congenital anomalies in the United States
  22. Short Communication
  23. Postnatal kidney maturation regulates renal artery myogenic constriction
  24. Letters to the Editor
  25. Ebola viral infection in pregnancy: a plea for specific clinical recommendations
  26. Magnesium may provide further benefit to hypothermia following perinatal asphyxia encephalopathy
  27. Congress Calendar
  28. Congress Calendar
https://doi.org/10.1515/jpm-2014-0086
Schlagwörter für diesen Artikel
Assisted reproduction technique; peripartum cardiomyopathy; pregnancy and postpartum

Artikel in diesem Heft

  1. Frontmatter
  2. Academy’s Corner
  3. Maternal mortality: an ongoing challenge to perinatal medicine
  4. Fetal mild ventriculomegaly: still a challenging problem
  5. Review article
  6. Natural killer cell in the developing life
  7. Original articles – Obstetrics
  8. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques
  9. Individual consultant practice does not affect the overall intervention rate: a 6-year study
  10. Identifying high-risk subgroups for alcohol consumption among younger and older pregnant women
  11. Ultrasonographic severity scoring of non-immune hydrops: a predictor of perinatal mortality
  12. Controversial clinical practices for patients with preeclampsia or HELLP syndrome: a survey
  13. Inter- and intra-observer variability in cervical measurement by ultrasound in the first and second trimesters of pregnancy: does it matter?
  14. Personnel-itis: a myth or a pathology? A retrospective analysis of obstetrical and perinatal outcomes for physicians and nurses
  15. Placenta-secreted circulating markers in pregnant women with obstructive sleep apnea
  16. Variations of blood cells in prediction of gestational diabetes mellitus
  17. Peripartum cardiomyopathy – risk factors, characteristics and long-term follow-up
  18. Original article – Fetus
  19. Effect of assisted reproductive technology on fetal brain development assessed by prenatal ultrasonography
  20. Original article – Newborn
  21. Racial/ethnic differences in the birth prevalence of congenital anomalies in the United States
  22. Short Communication
  23. Postnatal kidney maturation regulates renal artery myogenic constriction
  24. Letters to the Editor
  25. Ebola viral infection in pregnancy: a plea for specific clinical recommendations
  26. Magnesium may provide further benefit to hypothermia following perinatal asphyxia encephalopathy
  27. Congress Calendar
  28. Congress Calendar
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