Peripartum Cardiomyopathy Due to Gestational Hypertension and Tocolytic Therapy

BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare and sometimes fatal systolic heart failure that affects women during late pregnancy or the early postpartum period. The risk factors contributing to this condition are advanced maternal age, multiparity, administration of tocolytic agents, underlying cardiac disease, iatrogenic volume overload, preeclampsia, hypertension. In patients with gestational hypertension (GH) other factors, close monitoring mandatory as well in CASE REPORT: A 38-year-old patient previously treated for endometriosis, infertility, GH was transferred from clinic gynecology due diagnosed congestive failure. 5 days before admission, she gave birth her first child. Before delivery, therapy. She received methyldopa which abruptly discontinued after delivery. Echocardiography on admission revealed moderately reduced left ventricular (LV) function an ejection fraction (EF) 37% dilated ventricle pulmonary artery secondary LV During hospitalization, signs but good response parenteral diuretic additionally guideline-recommended controlled echocardiography showed improvement EF 42%. CONCLUSION: PPCM high morbidity mortality. An LVEF <30%, marked dilatation, end-diastolic diameter >6.0 cm, RV involvement associated adverse outcomes. Although delivery fetus placenta triggers resolution symptoms recovery nonpregnant state various organisms, contrary happens blood pressure. Its peak time 3–6 Hypertension medication must not be immediately terminated. Prolonged therapy factor causing decreased baroreflex sensitivity. Patients should closely monitored eventual complications.