Brief communication: Outcomes of subsequent pregnancy after peripartum cardiomyopathy: a case series from Haiti.

Abstract

BACKGROUND: Maternal risks with pregnancies after an index diagnosis of peripartum cardiomyopathy (PPCM) are inadequately understood. OBJECTIVE: To describe the clinical outcomes of subsequent pregnancy in Haitian women with PPCM. DESIGN: Prospectively identified cases from a defined population base, 2000-2005. SETTING: Hôpital Albert Schweitzer, Deschapelles, Haiti. PATIENTS: 15 patients with PPCM and subsequent pregnancies among 99 prospectively identified patients with PPCM. MEASUREMENTS: Clinical and echocardiographic parameters. RESULTS: Fifteen women with PPCM had 16 subsequent pregnancies after the index pregnancies. Eight of these patients experienced worsening heart failure; of these, 1 died and 1 regained normal left ventricular systolic function. Seven patients tolerated pregnancy without worsening heart failure, and ventricular function recovered in these patients within 30 months after the subsequent pregnancy. LIMITATIONS: The results may not apply to non-Haitian women, and power was insufficient to identify factors that might predict recovery (n = 15). CONCLUSIONS: Half of the women with subsequent pregnancy after PPCM experienced worsening heart failure and long-term systolic dysfunction, while the other half experienced no deterioration and regained normal left ventricular systolic function.