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Assessment of Maternal Vascular Remodeling During Pregnancy in the Mouse Uterus

Assessment of Maternal Vascular Remodeling During Pregnancy in the Mouse Uterus

Published on: December 5, 2015

Cardiomyopathy in pregnancy: a retrospective study.

P S Bernstein¹, U Magriples

¹Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York 10461-2373, USA.

American Journal of Perinatology

|June 21, 2001

Summary

Women with dilated cardiomyopathies (DCM) can safely carry pregnancies, as outcomes were better than those with peripartum cardiomyopathy (PPCM). Stable DCM patients experienced no significant cardiac decline during pregnancy.

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Area of Science:

Cardiology
Maternal-Fetal Medicine
Reproductive Health

Background:

Traditionally, women with dilated cardiomyopathies (DCM) were advised against pregnancy due to concerns extrapolated from peripartum cardiomyopathy (PPCM) data.
The appropriateness of this extrapolation for women with pre-existing DCM is unclear.

Purpose of the Study:

To compare maternal and obstetric outcomes between women with pre-existing DCM and those with PPCM.
To inform counseling for women with DCM considering pregnancy.

Main Methods:

A 10-year retrospective comparative cohort study.
Inclusion criteria: women aged 15-40 diagnosed with cardiomyopathy (CM) prior to pregnancy (DCM group) or during/postpartum (PPCM group).
Comparison of 8 women with DCM against 23 women with PPCM.

Main Results:

Maternal outcomes were significantly worse in the PPCM group (3 deaths, 4 heart transplants) compared to the DCM group (p=0.05).
One DCM patient with low ejection fraction underwent transplantation after pregnancy termination for genetic reasons; others had stable cardiac status.
Infant outcomes were uniformly good in both groups.

Conclusions:

Peripartum cardiomyopathy (PPCM) is an acute condition with poorer prognosis than previously assumed.
Prognosis of PPCM should not dictate counseling for women with pre-existing DCM.
Women with stable DCM may have successful pregnancies without significant cardiac deterioration.