Key result
Peripartum cardiomyopathy significantly exaggerates the risk of thromboembolism, and timely initiation of anticoagulation with low-molecular-weight heparin is recommended to prevent catastrophic events.
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Peripartum cardiomyopathy creates a highly prothrombotic state requiring careful risk stratification and consideration of anticoagulation to prevent catastrophic thromboembolic events.
Pregnancy with peripartum cardiomyopathy (PPCM) is associated with a prothrombotic state. The procoagulant system is activated, signaled by the elevated levels of clotting factors. The natural anticoagulation mechanisms are suppressed, along with the fibrinolytic system. Heart failure (HF) is also known to activate platelets favoring thrombus formation. HF with reduced ejection fraction secondary to multi-factorial etiology in PPCM predisposes to intracardiac thrombus formation and embolic complication, jeopardizing maternal and fetal safety. Anticoagulation with heparin for thrombo-prophylaxis and treatment can prevent the formation and extension of the clot. Risk stratification, prompt identification of patients with intracardiac thrombus, and timely initiation of anticoagulation can mitigate the catastrophic thromboembolic episodes.
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Badge et al. (2025) conducted a review in Peripartum cardiomyopathy and thrombosis. Anticoagulation was evaluated. Peripartum cardiomyopathy significantly exaggerates the risk of thromboembolism, and timely initiation of anticoagulation with low-molecular-weight heparin is recommended to prevent catastrophic events.
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