Document Detail


Peripartum cardiomyopathy.
MedLine Citation:
PMID:  19655159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
According to current definition, peripartum cardiomyopathy (PPCM) is a rare disorder in which left ventricular dysfunction and symptoms of heart failure occur in the last month of pregnancy. It has been reported that the incidence of PPCM is 1 in 3,000-4,000 live births. The pathogenesis is poorly understood, however, infectious, immunologic, and nutritional causes have been hypothesized. Clinical presentation includes usual signs and symptoms of heart failure, and unusual presentations such as thromboembolism. Diagnosis is based upon the clinical presentation of congestive heart failure and the objective evidence of left ventricular systolic dysfunction. Early diagnosis and initiation of treatment are essential to optimize pregnancy outcome. Patients with systolic dysfunction during pregnancy are treated similar to patients who are not pregnant. The mainstays of medical therapy are digoxin, loop diuretics, sodium restriction and afterload reducing agents (hydralazine and nitrates). Due to a high risk for venous and arterial thrombosis, anticoagulation with subcutaneous heparin should be instituted. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy because of severe adverse neonatal effects. Effective treatment reduces mortality rates and increases the number of women who fully recover left ventricular systolic function. The prognosis is poor in patients with persistent cardiomyopathy. Subsequent pregnancies are often associated with recurrence of left ventricular systolic dysfunction.
Authors:
Melita Moioli; Mario Valenzano Menada; Giorgio Bentivoglio; Simone Ferrero
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-08-05
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  281     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2009-12-25     Completed Date:  2010-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  183-8     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, San Martino Hospital, University of Genoa, Largo R. Benzi 1, 16132, Genoa, Italy. melitamoioli@libero.it
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MeSH Terms
Descriptor/Qualifier:
Cardiomyopathies / epidemiology,  physiopathology*,  therapy
Female
Humans
Pregnancy
Pregnancy Complications, Cardiovascular / epidemiology,  physiopathology*,  therapy

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