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Successful outcome in a patient with idiopathic dilated cardiomyopathy with bad obstetric history with no live issue

Renuka Malik, Preeti Sharma.

Abstract
Primary dilated cardiomyopathy is rare in women of childbearing age. Pregnancy in dilated cardiomyopathy carries high risk and can have adverse feto-maternal outcome even death. Traditionally patients of dilated cardiomyopathy with poor cardiac reserve are advised against pregnancy or termination of pregnancy in first trimester. A 26 year old patient with 5 abortions and no live issue diagnosed with Idiopathic dilated cardiomyopathy at 30 weeks at echocardiography (ECHO) with left ventricular ejection fraction (LVEF) of 25% (WHO class IV). She had no cardiac consultation earlier than in this pregnancy, though her earlier abortions were in hospital. Patient was kept with close monitoring. Dopplers parameters showed continued worsening. An emergency caesarean was done because of absent flow in ductus venosus at 34 weeks and a live child of 2.010 kg delivered. To date both mother and child are doing well. Awareness of such condition and a multidisciplinary approach is required in management of cardiomypathy in pregnancies, whose symptoms mimic that of normal pregnancy and can have adverse feto-maternal outcome.

Key words: Idiopathic dilated cardiomyopathy, Peripartum cardiomyopathy



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