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Nascer e Crescer
Print version ISSN 0872-0754On-line version ISSN 2183-9417
Abstract
DIAS, Joana Portela; COROADO, Mariana; BRAGA, António and BRAGA, Jorge. Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes. Nascer e Crescer [online]. 2022, vol.31, n.4, pp.382-385. Epub Dec 31, 2022. ISSN 0872-0754. https://doi.org/10.25753/birthgrowthmj.v31.i4.25231.
Introduction:
Pregnancy is associated with relevant hemodynamic changes that can lead to clinical decompensation in women with previous cardiomyopathy. Given this risk, the literature generally advises against pregnancy in these cases, but this recommendation is controversial.
Case description:
Herein is described the case of a woman with dilated cardiomyopathy and left ventricular ejection fraction of 28% who decided to proceed with pregnancy. The baby was born by cesarean section at 32 gestational weeks, with good neonatal outcomes. However, significant cardiac deterioration after birth determined the need for cardiac transplant.
Discussion:
The physiological changes that characterize pregnancy can be too demanding for women with previous cardiomyopathy and low left ventricular ejection fraction. In these cases, pregnancy should be monitored by a multidisciplinary team, with cardiac disease control. The timing and mode of delivery is still controversial, given the lack of studies in the area. In addition, the long-term impact of pregnancy and delivery on cardiac function should not be neglected.
Keywords : cardiovascular pregnancy complication; dilated cardiomyopathy; implanted cardioverter-defibrillator; left ventricular dysfunction; pregnancy.