Risk Stratification for Subsequent Pregnancy After Prior Peripartum Cardiomyopathy

AbstractPurpose of reviewPeripartum cardiomyopathy (PPCM) is a rare but serious cardiac complication of pregnancy. Patients with PPCM may not have completed their reproductive years and may desire future pregnancies. This review summarizes the epidemiology and pathophysiology of PPCM and gives an overview of the current knowledge of risk factors that can be used to assess the risk of pregnancy after PPCM.Recent findingsAn increasing body of work has been reported on pregnancy outcomes in women with a history of PPCM. The most dominant determinate of poor outcome in subsequent pregnancies (SSP) is left ventricular ejection fraction (LVEF), where persistently impaired LVEF pertains significant morbidity and mortality associated with future pregnancies. Major society guidelines recommend against SSP in women with PPCM who do not recover their LVEF. However, some experts discourage SSP even among women who normalized their LVEF due to reports of recurrence of heart failure. At present, limited data exists to allow risk stratification in this population; therefore, assessment for the lack of subclinical cardiac dysfunction may provide some reassurance.SummaryThe care of women with PPCM and reproductive health for women after PPCM can be challenging. Robust data highlights the increased risk for women with persistently depressed LVEF; however, evidence to risk stratify those with normalized cardiac function is limited. Going forward, further studies investigating factors predicting...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research