Cardiac arrest during emergency cesarean section for severe pre-eclampsia and peripartum cardiomyopathy

To present the correlation between severe pre-eclampsia and peripartum cardiomyopathy in pregnancy.

A 41-year-old parturient, gravida 3, para 1, at 34 4/7 weeks' gestation, was diagnosed with severe pre-eclampsia. At the time of admission, a plain chest film disclosed bilateral pleural effusions. An emergent cesarean section was planned because of decreased fetal movement, heavy daily protein loss, and bilateral pleural effusions. During the cesarean section, she developed shock with acute respiratory failure. She underwent advanced cardiac life support and intubation with mechanical ventilator support. Peripartum cardiomyopathy was subsequently diagnosed by echocardiography.

The presented case demonstrates that routine echocardiography is highly recommended for suspected peripartum cardiomyopathy in gravidas with severe pre-eclampsia and symptoms or signs of heart failure.