Peripartum Cardiomyopathy: 12 Cases / 대한산부인과학회지

ABSTRACT

OBJECTIVE: Our objective was to describe the clinical characteristics, diagnosis and treatment of 12 cases of peripartum cardiomyopathy (PPCM). METHODS: We retrospectively reviewed 12 cases of PPCM diagnosed by clinical and echocardiographic criteria between Jan 1997 and Dec 2004. RESULTS: The incidence of PPCM was 1 in 576 deliveries. The most common clinical and laboratory findings were dyspnea (100%), pulmonary edema (83.3%), and tachycardia (83.3%). The mean left ventricular ejection fraction (EF) was 34.2% (range, 23-44.6%), and the mean fractional shortening (FS) on echocardiography was 15.9% (range, 10.2-23%). Eight patients (67%) were diagnosed after delivery, and four patients (33%) were diagnosed before delivery. The mean interval from the onset of symptoms to evaluation with echocardiography was 72 hours (range, 7 hr-10 day). Suspicion and evaluation of PPCM was delayed in discharged women, our period of inexperience, and during the antepartum period. We did not observe any mortality case in our study population. Six patients improved, while three patients showed persistent ventricular dysfunction at follow-up echocardiography. CONCLUSION: All of our patients represented with the symptoms and sings of congestive heart failure, although which were similar to those of late pregnancy. Therefore, we suggest that PPCM should be considered and evaluated, whenever peripartum dyspnea, pulmonary edema, and tachycardia especially develop.