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Peripartum cardiomyopathy management: insights from a Latin American case report.

Arch Peru Cardiol Cir Cardiovasc

December 2024

Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru. Universidad San Ignacio de Loyola Vicerrectorado de Investigación Universidad San Ignacio de Loyola Lima Peru.

Peripartum cardiomyopathy (PPCM) is a potentially life-threatening condition that can occur during the late pregnancy or puerperium. A 31-year-old woman with a recent twin pregnancy presented with heart failure symptoms nine days postpartum. On admission, she had volume overload and hemodynamic compromise, which was rapidly reversed with inotropic levosimendan support.

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Front Glob Womens Health

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Department of Obstetrics and Gynecology, Sandwell and West Birmingham NHS Trust, Birmingham, United Kingdom.

Key Content: •Massive pulmonary embolism (PE) during pregnancy or the postpartum period is a rare but potentially lethal event.•Physiological changes in the coagulation system during pregnancy and puerperium would lead to a hypercoagulable state.•Diagnosis of PE in pregnancy remains a challenge due to physiological changes in pregnancy.

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The IMmediate Postpartum Access to Cardiac Therapy (IMPACT) procedure is a multidisciplinary, collaborative, highly coordinated clinical service in which a planned delivery and intensive neonatal care are offered for conditions where there is a high likelihood of postnatal instability. This process includes prenatal consultation with the parent(s), involving each service engaged with the delivery, postnatal resuscitation, and procedural care. A Cesarean section delivery is planned in an operating room with immediate access to a multifunctional procedural suite where the neonate can undergo rapid cardiac evaluation and initiation of interventional treatments which can have a positive, life-saving impact.

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Diaphragmatic rupture during labor is an exceptionally rare condition, with a limited number of cases reported in the literature. A recent review underscores the rarity of this complication and emphasizes the associated challenges in diagnosis and management. This case report presents a postpartum diaphragmatic rupture, focusing on the diagnostic and therapeutic challenges it poses, particularly in the context of unsupervised deliveries.

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Rationale: Postpartum haemorrhage (PPH) is common and potentially life-threatening. The antifibrinolytic drug tranexamic acid (TXA) is thought to be effective for treating PPH. There is growing interest in whether TXA is effective for preventing PPH after vaginal birth.

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