Key result
Diuretics, inotropes, and ventilation successfully resolve acute pulmonary edema from peripartum cardiomyopathy during cesarean delivery.
Why the study?
Peripartum cardiomyopathy is often unrecognized because its symptoms mimic those of normal pregnancy, and its incidence varies widely.
Case Report (n=1)
No
May inform rescue strategies in peripartum cardiomyopathy; hypothesis-generating and should not change practice.
Peripartum cardiomyopathy (PPCM) is defined as the onset of acute heart failure without any demonstrable cause in the last trimester of pregnancy or within the first 6 months after delivery. It is characterized by ventricular dilatation and poor ventricular contractility but it is often unrecognized because the symptoms of normal pregnancy commonly mimic those of mild heart failure. The incidence varies from 1 in 1,300 to 1 in 15,000 pregnancies. We encountered a patient, who developed sudden pulmonary edema during an elective cesarean section. Echocardiography performed after the surgery showed a low ejection fraction (20%). The patient was treated with diuretics and inotropic agents and mechanical ventilation with positive end-expiratory pressure. She was discharged uneventfully on the postoperative 11th day.
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Lee et al. (2007) conducted a case report in Peripartum cardiomyopathy (n=1). Diuretics, inotropic agents, and mechanical ventilation with PEEP was evaluated on Clinical recovery. A patient who developed sudden pulmonary edema during an elective cesarean section due to peripartum cardiomyopathy was successfully treated with diuretics, inotropes, and mechanical ventilation.
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