A contemporary review of peripartum cardiomyopathy

Patel, Peysh A; Roy, Ashwin; Javid, Rabeia; Dalton, John Aw

doi:10.7861/clinmedicine.17-4-316

Cited by 21 publications

(13 citation statements)

References 41 publications

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“…Induction of labour is similarly considered for an obstetric indication for delivery or for deteriorating cardiac function. 30 If the fetus needs to be delivered prematurely, intramuscular corticosteroids are administered between 24 weeks of gestation and 35 weeks and 6 days gestational age to promote fetal lung maturation. 31 A detailed intrapartum plan should be available in the woman's maternity record for staff to follow when she presents in labour.…”

Section: Advanced Heart Failure Therapymentioning

confidence: 99%

“…A 30°l eft tilt is essential to avoid aortocaval compression. 30 Lowdose regional analgesia is safe because it avoids cardiac instability during labour and birth. Limiting the active phase of the second stage of labour with the aid of instrumental delivery helps to negate the cardiovascular effects of prolonged pushing.…”

Section: Advanced Heart Failure Therapymentioning

confidence: 99%

“…Limiting the active phase of the second stage of labour with the aid of instrumental delivery helps to negate the cardiovascular effects of prolonged pushing. 30 In the third stage, slow infusion of oxytocin is the first-line recommended drug to avoid sudden haemodynamic change. Misoprostol and carboprost (PGF2a) are used as second-line treatment to reduce risk of haemorrhage.…”

Section: Advanced Heart Failure Therapymentioning

confidence: 99%

“…9 Currently, the overall mortality rate has been estimated to be 10%. 30 Afro-Caribbean lineage is associated with a reduced likelihood of recovery. 9 In contrast, PPCM associated with hypertension has been associated with a more successful recovery.…”

Section: Prognosismentioning

confidence: 99%

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Peripartum cardiomyopathy

Kulkarni

Squire

Hogrefe

et al. 2021

The Obstetric & Gynaecologis

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The increasing incidence of peripartum cardiomyopathy (PPCM) is associated with advancing maternal age, multiple gestation, obesity and increasing awareness of the implications of the disease. A 'two-hit' model of pathogenesis has been proposed, wherein a vascular insult secondary to hormonal effects of advanced pregnancy prompt cardiomyopathy changes in women with underlying genetic predisposition. The emphasis should be on making a diagnosis, and not simply excluding a diagnosis. Early involvement of a multidisciplinary team and senior clinicians is imperative in managing these women effectively. Newer pharmacotherapeutic agents to treat PPCM lack adequate evidence, making their use experimental. Learning objectivesTo understand the principles of clinical assessment, which sometimes mimic physiological symptoms of pregnancy. To understand how to manage women with PPCM in a multidisciplinary setting and become familiar with the various pharmacotherapies available. To understand the importance of counselling women on long-term prognosis and implications on future pregnancy. Ethical issuesThe unexpected presentation of the disease and the acuity of illness profoundly affects women at an early stage of their lives. Sparse knowledge means there is uncertainty on the long-term prognosis, which poses a challenge in counselling for future pregnancies.

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Section: Advanced Heart Failure Therapymentioning

confidence: 99%

Section: Advanced Heart Failure Therapymentioning

confidence: 99%

Section: Advanced Heart Failure Therapymentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

See 2 more Smart Citations

Peripartum cardiomyopathy

Kulkarni

Squire

Hogrefe

et al. 2021

The Obstetric & Gynaecologis

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“…Informing women considering pregnancy of their risk for pregnancy-specific CVDs will help them to make an informed decision. Women at higher risk include those who are older than age 30 years, (Arany, 2018) are overweight or obese, (Patel et al, 2017;Shen et al, 2017) have a preexisting metabolic or cardiovascular condition such as diabetes or hypertension, (Patel et al, 2017;Shen et al, 2017) had a previous pregnancy complicated by a pregnancy-specific CVD, or have a family history of pregnancy-specific CVDs (Sliwa et al, 2017). Furthermore, having a lower educational level is associated with higher risk for gestational hypertension and preeclampsia, (Umesawa et Kobashi, 2017) and being of African descent is associated with higher risk for peripartum cardiomyopathy.…”

Section: Risk Factors and Clinical Assessmentmentioning

confidence: 99%

CE: Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy: A Clinical Review

Maheu‐Cadotte¹,

Pépin²,

Lavallée³

et al. 2019

AJN, American Journal of Nursing

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Gestational hypertension, preeclampsia, and peripartum cardiomyopathy are among the most common and often severe pregnancy-specific cardiovascular diseases (CVDs) and causes of complications in pregnancy. This clinical review provides nurses with an overview of pregnancyspecific CVDs, outlines their pathophysiology, and discusses risk factors and assessment. It describes management interventions according to timing: the antepartum, intrapartum, and postpartum phases are each addressed.

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