Five-Year Follow-Up of Peripartum Cardiomyopathy

Peripartum cardiomyopathy is a type of cardiomyopathy found in pregnancy and up to 5 months after delivery. There is no identifiable cause for myocardial dysfunction in these patients. In this study, we evaluated our patients for symptoms, signs, functional class, prognosis and complications.Methods- Eighteen pregnant patients with myocardial dysfunction and diagnosis of peripartum cardiomyopathy were evaluated from Dec. 1998 to Dec. 2007. All patients had echocardiography follow up, and symptoms and signs of every patient were evaluated for 5 years. Results- Mean age of patients was 34پ}5 yrs, mean left ventricular ejection fraction (LVEF) according to echo was 27پ}5%, and dyspnea was present in 100% of patients. Chest pain was present in 61.11%, arrhythmia in 50%, edema in 72.22% and hypertension in 27.77%. During follow up, there were 22.22% next pregnancies in 5 years. Mortality occurred in 16.66%, remission in 27.77%, partial resolution of symptoms and signs and improved LVEF in 22.22%, and no improvement in 33.33%. Vaginal delivery was performed in 77.77% and cesarean section in 22.22% of patients. Conclusion- Peripartum cardiomyopathy is a lethal disease during pregnancy. We do not recommend allowing next pregnancies and cesarean section is lethal; vaginal delivery is the best method of parturition for these patients (Iranian Heart Journal 2008; 9 (1): 14-17).