Peripartum cardiomyopathy is a severe pregnancy-associated myocardial disease with a 50% recovery rate at 6 months, and future pregnancies are contraindicated due to high recurrence risk.
Supports close monitoring for incomplete recovery in PPCM; leaves open prospective trials of predictors and therapies.
Peripartum Cardiomyopathy is a pregnancy associated rare but severe myocardial disease. The incidence of PPCM is about 1 in 3186 live births in United States. Causes include viral infections, toxins, environmental and geographic factors, familial predisposition, Hormonal abnormalities, haemodynamic burden of pregnancy, malnutrition, inflammation, etc. NT-proBNP, Cathepsin D, tyrosine kinase SFlt1 may be elevated and can be used as biomarkers to diagnose PPCM. Restriction of dietary sodium, beta-blockers, diuretics-thiazide and furosemide, in lowest possible doses can be given for symptomatic management. Prognosis of PPCM is positively related to the recovery of ventricular failure. Only about 50% women with PPCM recover baseline ventricular function within 6 months of delivery. Failure of heart size to return to normal is associated with increased mortality and morbidity. Future pregnancies are not recommended in patient with PPCM, as there is an increased risk for recurrence of PPCM in the subsequent pregnancy.
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Jain et al. (2016) studied this question.
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