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Korean Journal of Obstetrics & Gynecology 2006;49(10):2087-2095.
Published online October 1, 2006.
Clinical characteristics and prognosis of peripartum cardiomyopathy.
Yong Hyuk Yang, Ka Young Lee, Hee Jung Hwang, Yong Kyoon Cho, Bok Rin Kim, Hoon Choi, Chul Min Lee, Ji Kyung Ko
Department of Obstetrics and Gynecology, Inje University, Sanggye Paik Hospital, Seoul, Korea. ymkcho@sanggyepaik.ac.kr
Abstract
OBJECTIVE
To examine clinical characteristics and risk factors and to assess prognosis of peripartum cardiomyopathy (PPCM). METHODS: We retrospectively reviewed the medical records of 10 patients with confirmed PPCM by clinical symptoms and echocardiography, who delivered between January 1995 and December 2005 at our Hospital. Clinical and serial echocardiographic data of these patients were collected. RESULTS: Mean maternal age at the time of diagnosis was 28.8+/-3.2 years and the mean gestational age was 37(+3)+/-4 weeks. Common associated conditions were nulliparity (90%), cesarean delivery (70%), anemia (70%), preeclampsia (60%), transfusion before diagnosis (40%), twin pregnancy (30%). At the time of diagnosis, the mean left ventricular ejection fraction (EF) was 42.84+/-9.69%, fractional shortening (FS) was 23.41+/-5.49%, and left ventricular end diastolic dimension (LVEDD) was 5.58+/-0.55 cm/m2. Normalization of left ventricular function occurred in 8 patients (80%). After recovery of the left ventricular function, mean EF was 61.41+/-4.21%, FS was 34.08+/-3.26%, and LVEDD was 4.68+/-0.76 cm/m2. Incidence of PPCM was 1 in 2455 pregnancies, and maternal mortality was 12.5% in 10 months follow-up. CONCLUSION: The risk of PPCM may increase in puerperal women with rapid dramatic hemodynamic change. Echocardiography may provide significant prognostic information.
Key Words: Peripartum cardiomyopathy, Pregnancy, Heart failure, Echocardiography


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