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

James D. Fett, MD; Len G. Christie, MD; and Joseph G. Murphy, MD
[+] Article and Author Information

From Hôpital Albert Schweitzer, Deschapelles, Haiti; Oregon Health Sciences University, Portland, Oregon; and Mayo Clinic, Rochester, Minnesota.


Acknowledgments: The authors thank the patients, volunteers, and staff at Hôpital Albert Schweitzer.

Grant Support: No grants were received. Funding was provided through charitable contributions (Pierre Paulette Peripartum Cardiomyopathy Fund) that are separate from the operating budget of the Hôpital Albert Schweitzer.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Joseph G. Murphy, MD, Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; e-mail, murphy.joseph@mayo.edu.

Current Author Addresses: Dr. Fett: PPCM Project, Hôpital Albert Schweitzer, Deschapelles, Haiti, c/o 611 Sumner Avenue, Aberdeen, WA 98520.

Dr. Christie: Oregon Cardiovascular Teachings Ltd., 1461 Hilyard Street, Eugene, OR 97405.

Dr. Murphy: Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Author Contributions: Conception and design: J.D. Fett.

Analysis and interpretation of the data: J.D. Fett, L.G. Christie, J.G. Murphy.

Drafting of the article: J.D. Fett, J.G. Murphy.

Critical revision of the article for important intellectual content: J.D. Fett, J.G. Murphy.

Final approval of the article: J.D. Fett, L.G. Christie, J.G. Murphy.

Provision of study materials or patients: J.D. Fett, L.G. Christie.

Statistical expertise: J.D. Fett, J.G. Murphy.

Obtaining of funding: J.D. Fett, L.G. Christie, J.G. Murphy.

Administrative, technical, or logistic support: J.D. Fett, L.G. Christie, J.G. Murphy.

Collection and assembly of data: J.D. Fett, L.G. Christie.


Ann Intern Med. 2006;145(1):30-34. doi:10.7326/0003-4819-145-1-200607040-00007
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Our study focuses on women with subsequent pregnancies among 99 prospectively identified patients with PPCM who were enrolled in the Hôpital Albert Schweitzer Peripartum Cardiomyopathy Registry from 1 February 2000 to 31 January 2005. We included patients if their disease met accepted definition criteria (68) for PPCM: 1) the onset of heart failure in the month before delivery to 5 months after delivery, 2) no preexisting heart disease, 3) no other cause identified for the heart failure, and 4) echocardiographic evidence of left ventricular systolic dysfunction with ejection fraction less than 0.45. We confined the study to HIV-negative patients.

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Figure.
Left ventricular ejection fraction in 15 patients with peripartum cardiomyopathy (PPCM) who experienced a subsequent pregnancy with (n= 8) or without (n= 7) recovery during follow-up.

0 = at diagnosis, PPCM index pregnancy; 1 = postpartum to index pregnancy; 2 = postpartum to subsequent pregnancy. Solid lines connect individual patients' left ventricular ejection fractions. Dashed lines are smooth mean estimates from cubic smoothing splines. Last point of data collection was 27 January 2006.

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