Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes

Detalhes bibliográficos
Autor(a) principal: Portela Dias, Joana
Data de Publicação: 2022
Outros Autores: Coroado, Mariana, Braga, António, Braga, Jorge
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.25753/BirthGrowthMJ.v31.i4.25231
Resumo: Introduction: Pregnancy is associated with relevant hemodynamic changes that can lead to clinical decompensation in women with previous cardiomyopathy. Given this risk, the literature generally advises against pregnancy in these cases, but this recommendation is controversial. Case description: Herein is described the case of a woman with dilated cardiomyopathy and left ventricular ejection fraction of 28% who decided to proceed with pregnancy. The baby was born by cesarean section at 32 gestational weeks, with good neonatal outcomes. However, significant cardiac deterioration after birth determined the need for cardiac transplant. Discussion: The physiological changes that characterize pregnancy can be too demanding for women with previous cardiomyopathy and low left ventricular ejection fraction. In these cases, pregnancy should be monitored by a multidisciplinary team, with cardiac disease control. The timing and mode of delivery is still controversial, given the lack of studies in the area. In addition, the long-term impact of pregnancy and delivery on cardiac function should not be neglected.
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spelling Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomesCardiomiopatia dilatada na gravidez: Para lá dos resultados obstétricosCase ReportsIntroduction: Pregnancy is associated with relevant hemodynamic changes that can lead to clinical decompensation in women with previous cardiomyopathy. Given this risk, the literature generally advises against pregnancy in these cases, but this recommendation is controversial. Case description: Herein is described the case of a woman with dilated cardiomyopathy and left ventricular ejection fraction of 28% who decided to proceed with pregnancy. The baby was born by cesarean section at 32 gestational weeks, with good neonatal outcomes. However, significant cardiac deterioration after birth determined the need for cardiac transplant. Discussion: The physiological changes that characterize pregnancy can be too demanding for women with previous cardiomyopathy and low left ventricular ejection fraction. In these cases, pregnancy should be monitored by a multidisciplinary team, with cardiac disease control. The timing and mode of delivery is still controversial, given the lack of studies in the area. In addition, the long-term impact of pregnancy and delivery on cardiac function should not be neglected.Introdução: A gravidez está associada a importantes alterações hemodinâmicas que podem conduzir a descompensação clínica em mulheres com cardiomiopatia de base. Por esse motivo, a literatura desaconselha a gravidez nestes casos, mas esta recomendação não é consensual. Descrição do caso clínico: É descrito o caso de uma mulher com cardiomiopatia dilatada e fração de ejeção ventricular esquerda de 28%, que optou por prosseguir com a gravidez. O bebé nasceu por cesariana às 32 semanas de gestação, com bons resultados neonatais. Contudo, subsequente deterioração cardíaca materna determinou a necessidade de realização de transplante cardíaco. Conclusão: As alterações fisiológicas características da gravidez podem não ser bem toleradas em mulheres com cardiomiopatia prévia e baixa fração de ejeção do ventrículo esquerdo. Nestes casos, a gravidez deve ser monitorizada por uma equipa multidisciplinar, com controlo da patologia cardíaca. O momento e tipo de parto são ainda controversos, dada a falta de dados nesta área. Para além disso, o impacto a longo prazo da gravidez e parto na função cardíaca não deve ser negligenciado.Centro Hospitalar Universitário do Porto2022-12-27info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25753/BirthGrowthMJ.v31.i4.25231eng2183-9417Portela Dias, JoanaCoroado, MarianaBraga, AntónioBraga, Jorgeinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-12-29T17:00:48Zoai:ojs.revistas.rcaap.pt:article/25231Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:29:01.890200Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes
Cardiomiopatia dilatada na gravidez: Para lá dos resultados obstétricos
title Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes
spellingShingle Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes
Portela Dias, Joana
Case Reports
title_short Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes
title_full Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes
title_fullStr Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes
title_full_unstemmed Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes
title_sort Dilated cardiomyopathy in pregnancy: Beyond obstetric outcomes
author Portela Dias, Joana
author_facet Portela Dias, Joana
Coroado, Mariana
Braga, António
Braga, Jorge
author_role author
author2 Coroado, Mariana
Braga, António
Braga, Jorge
author2_role author
author
author
dc.contributor.author.fl_str_mv Portela Dias, Joana
Coroado, Mariana
Braga, António
Braga, Jorge
dc.subject.por.fl_str_mv Case Reports
topic Case Reports
description Introduction: Pregnancy is associated with relevant hemodynamic changes that can lead to clinical decompensation in women with previous cardiomyopathy. Given this risk, the literature generally advises against pregnancy in these cases, but this recommendation is controversial. Case description: Herein is described the case of a woman with dilated cardiomyopathy and left ventricular ejection fraction of 28% who decided to proceed with pregnancy. The baby was born by cesarean section at 32 gestational weeks, with good neonatal outcomes. However, significant cardiac deterioration after birth determined the need for cardiac transplant. Discussion: The physiological changes that characterize pregnancy can be too demanding for women with previous cardiomyopathy and low left ventricular ejection fraction. In these cases, pregnancy should be monitored by a multidisciplinary team, with cardiac disease control. The timing and mode of delivery is still controversial, given the lack of studies in the area. In addition, the long-term impact of pregnancy and delivery on cardiac function should not be neglected.
publishDate 2022
dc.date.none.fl_str_mv 2022-12-27
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv https://doi.org/10.25753/BirthGrowthMJ.v31.i4.25231
url https://doi.org/10.25753/BirthGrowthMJ.v31.i4.25231
dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 2183-9417
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dc.publisher.none.fl_str_mv Centro Hospitalar Universitário do Porto
publisher.none.fl_str_mv Centro Hospitalar Universitário do Porto
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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