Brief Communication: Outcomes of Subsequent Pregnancy after Peripartum Cardiomyopathy: A Case Series from Haiti

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Abstract
Maternal risks with pregnancies after an index diagnosis of peripartum cardiomyopathy (PPCM) are inadequately understood. To describe the clinical outcomes of subsequent pregnancy in Haitian women with PPCM. Prospectively identified cases from a defined population base, 2000–2005. Hôpital Albert Schweitzer, Deschapelles, Haiti. 15 patients with PPCM and subsequent pregnancies among 99 prospectively identified patients with PPCM. Clinical and echocardiographic parameters. Fifteen women with PPCM had 16 subsequent pregnancies after the index pregnancies. Eight of these patients experienced worsening heart failure; of these, 1 died and 1 regained normal left ventricular systolic function. Seven patients tolerated pregnancy without worsening heart failure, and ventricular function recovered in these patients within 30 months after the subsequent pregnancy. The results may not apply to non-Haitian women, and power was insufficient to identify factors that might predict recovery (n = 15). Half of the women with subsequent pregnancy after PPCM experienced worsening heart failure and long-term systolic dysfunction, while the other half experienced no deterioration and regained normal left ventricular systolic function.