• Walkiria Samuel Avila, Maria Elisa Carneiro de Carvalho, Cleide K Tschaen, Eduardo Giusti Rossi, Max Grinberg, Charles Mady, and José Antonio Franchini Ramires.
• Instituto do Coração do Hospital das Clínicas - FMUSP, São Paulo, Brazil. walkria@incor.usp.br
• Arq. Bras. Cardiol. 2002 Nov 1; 79 (5): 484-93.

ObjectiveTo assess pregnancy outcome in women with peripartum cardiomyopathy and to compare it with idiopathic cardiomyopathy.MethodsTwenty-six pregnant women, aged 28.4+/-6.1 years, with dilated cardiomyopathy were followed. Eighteen patients had peripartum cardiomyopathy [11 with persistent left ventricular systolic dysfunction (EF=45.2+/-2) and 7 with recovered ventricular function (EF=62.3+/-3.6)]. The 8 remaining patients had idiopathic cardiomyopathy (EF= 43.5+/-4.1). During the prenatal period, limited physical activity and a low-sodium diet were recommended, and hospitalization was recommended when complications occurred.ResultsOf the 26 patients, 11 (42.3%) had a normal delivery; 9(35.5%) had cardiac complications, 6 (22.2%) had obstetric complications. Two patients (7.7%) died. Two preterm pregnancies occurred, with 26 health newborns (2 sets of twins). Two miscarriages took place. The cardiac complication rate during pregnancy was lower (p<0.009) in the peripartum cardiomyopathy group without ventricular dysfunction and greater (p=0.01) in the idiopathic group when compared with the peripartum group with ventricular dysfunction. Changes in left ventricular ejection fraction were not observed (p<0.05) in the postpartum period, when compared with that during pregnancy in the 3 groups.ConclusionPregnancy in patients with dilated cardiomyopathy is associated with maternal morbidity. Left ventricular function is a prognostic factor and must be the most parameter when counseling patients with peripartum cardiomyopathy about a new pregnancy.

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