Risk Of Heart Failure Relapse Need Not Deter Some Women From Pregnancy.(peripartum cardiomyopathy)

2001 JUN 14 - (NewsRx Network) -- Contrary to popular belief, women who experience a rare form of heart failure during pregnancy may be able to have another child if they have recovered fully and are willing to take some risks with their own health.

That is the message of an article in the May 24, 2001, issue of the New England Journal of Medicine, authored by researchers from the Keck School of Medicine of the University of Southern California and the LAC+USC Medical Center.

"The desire to have children is very strong," says Uri Elkayam, MD, professor of medicine, director of the Heart Failure Program at USC and the study's lead author. "A patient with heart disease is often advised by her physician to avoid pregnancy. I strongly believe that, as physicians, we are not supposed to make the decisions for the patients. Instead, we need to provide the patients with information and allow them and their families to make the decision."

The condition in question - called peripartum cardiomyopathy, or PPCM - is quite rare, occurring in just one out of 10,000 deliveries, explains Elkayam. who is considered one of the leading authorities on heart disease and pregnancy. "It presents, in most cases, in the last month of pregnancy or the first month after delivery, and definitely comes as a shock, because it appears in completely healthy young women," he says.

Women older than 30 years of age who carry more than one baby, are treated with tocolytic therapy to inhibit preterm contractions, or have developed pre-eclampsia (high blood pressure in pregnancy) are at increased risk of developing PPCM. Statistics show that approximately 20% of the women who develop this type of heart failure will continue to get worse, and either undergo heart transplantation or die.

And yet, says Elkayam, more than half of the women with PPCM recover, and when they do, they want to get on with their lives. "We get calls and e-mails from doctors and women all over the [U.S.]," says Elkayam, "and the most often-asked question is: 'Can I become pregnant again?"'

To answer that question, Elkayam and his USC colleagues conducted a survey of women with peripartum cardiomyopathy across the U.S. Not only did they look at the records of women who had survived the condition and became pregnant a second time, but they also interviewed those women or their physicians. In the end, they looked at a group of 44 women who had undergone a total of 60 pregnancies after ...