Document Detail


Maternal and fetal outcomes of subsequent pregnancies in women with peripartum cardiomyopathy.
MedLine Citation:
PMID:  11372007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Peripartum cardiomyopathy is a rare and sometimes fatal form of heart failure. Little is known about the outcomes of subsequent pregnancies in women who have had the disorder. METHODS: Through a survey of members of the American College of Cardiology, we identified 44 women who had had peripartum cardiomyopathy and had a total of 60 subsequent pregnancies. We then reviewed the medical records of these women and interviewed the women or their physicians. RESULTS: Among the first subsequent pregnancies in the 44 women, 28 occurred in women in whom left ventricular function had returned to normal (group 1) and 16 occurred in women with persistent left ventricular dysfunction (group 2). The pregnancies were associated with a reduction in the mean (+/-SD) left ventricular ejection fraction both in the total cohort (from 49+/-12 percent to 42+/-13 percent, P<0.001) and in each group separately (from 56+/-7 percent to 49+/-10 percent in group 1, P=0.002; and from 36+/-9 percent to 32+/-11 percent in group 2, P=0.08). During these pregnancies, a decrease of more than 20 percent in the left ventricular ejection fraction occurred in 21 percent of the women in group 1 and 25 percent of those in group 2, and symptoms of heart failure occurred in 21 percent of the women in group 1 and 44 percent of those in group 2. The mortality rate was 0 percent in group 1 and 19 percent in group 2 (P=0.06). In addition, the frequency of premature delivery was higher in group 2 (37 percent vs. 11 percent), as was that of therapeutic abortions (25 percent vs. 4 percent). CONCLUSIONS: Subsequent pregnancy in women with a history of peripartum cardiomyopathy is associated with a significant decrease in left ventricular function and can result in clinical deterioration and even death.
Authors:
U Elkayam; P P Tummala; K Rao; M W Akhter; I S Karaalp; O R Wani; A Hameed; I Gviazda; A Shotan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The New England journal of medicine     Volume:  344     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-11     Completed Date:  2001-05-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1567-71     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Southern California School of Medicine, Los Angeles 90033, USA. elkayam@hsc.usc.edu
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MeSH Terms
Descriptor/Qualifier:
Abortion, Therapeutic
Adult
Cardiomyopathies* / mortality,  physiopathology
Data Collection
Female
Follow-Up Studies
Humans
Pregnancy
Pregnancy Complications, Cardiovascular* / mortality,  physiopathology
Pregnancy Outcome / epidemiology*
Puerperal Disorders* / mortality
Recurrence
Retrospective Studies
Stroke Volume
Ventricular Dysfunction, Left / epidemiology
Comments/Corrections
Comment In:
N Engl J Med. 2001 May 24;344(21):1629-30   [PMID:  11372016 ]
Erratum In:
N Engl J Med 2001 Aug 16;345(7):552

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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