Risk factors for maternal outcome in pregnancy complicated with dilated cardiomyopathy

Objective:the goal of the study was to determine risk factors for maternal cardiac failure in pregnancy complicated with dilated cardiomyopathy (dcm).study design:the subjects were 29 patients diagnosed with dcm before conception or during the first 7 months of pregnancy. dcm was defined as left ventricle end-diastolic dimension (lvdd)⩾48 mm and/or fractional shortening (%fs)⩽30% on echocardiography. patients were followed until at least 1 year after delivery and were categorized into a poor prognosis group (n=6; death or end stage heart failure of new york heart association (nyha) class iii and iv) and a good prognosis group (n=23; all other cases).result:dcm was initially diagnosed during pregnancy in 6/6 and 8/23 patients in the poor and good prognosis groups, respectively (p<0.005). the %fs of the first test during pregnancy was 17.5±6.2 and 27.4±9.3% in the respective groups (p<0.005). in eight abortion cases with %fs 15.2±3.1%, %fs, cardiac function and nyha class were maintained until 20 months after abortion. there was no relationship between lvdd and maternal outcome.conclusion:onset during pregnancy and decreased %fs are risk factors for a poor maternal outcome in patients with dcm. abortion prevents further deterioration of cardiac function in patients with a very low %fs.