Mumbai: A 26-year-old woman, who gave premature birth at 28 weeks, was treated of petripartum cardiomyopathy (PPCM), a rare form of heart failure that occurs during the last month of pregnancy after giving premature birth at 28 weeks. The case highlighted the importance of multidisciplinary approach in managing high-risk pregnancies.
The patient, in her seventh month of pregnancy, was initially admitted to a hospital in Kurla with high blood pressure and vaginal bleeding. Despite being treated with medication, her condition worsened, leading to the premature birth of her baby at 28 weeks, weighing just 598 grams. Post-delivery, she experienced severe breathlessness, elevated blood pressure, and hypoxia, along with an increased respiratory rate.
The medical team secured her airway, breathing, and circulation before shifting her to the Intensive Care Unit (ICU). Comprehensive tests and scans revealed that she was suffering from PPCM, a rare form of heart failure that occurs during the last month of pregnancy or up to five months postpartum. This condition leads to the weakening of the heart muscle, making it difficult for the heart to pump blood efficiently. The patient had no prior history of heart disease, which made the diagnosis even more critical.
The patient was placed on a ventilator due to respiratory distress but later suffered from oliguria, a condition where urine output is decreased significantly, which indicates reduced kidney function. Further tests revealed inflammation in the kidneys, prompting the medical team to initiate dialysis to support her renal function. Despite her heart function being critically low at 15% compared to the normal 70-80%, her creatinine levels stabilised, allowing her to be weaned off the ventilator 48 hours after delivery.
Another dialysis session was performed to further enhance her kidney function and after four days, she was able to stand and perform simple tasks, marking a remarkable turnaround in her health. After a total of ten days in the hospital, the patient showed significant improvement. The patient was discharged after ten days, with a stable condition and a hopeful prognosis.
The medical team at Wockhardt Hospitals, Mumbai Central, including Dr. Gandhali Deorukhkar, OBGYN, Dr Kedar Toraskar, ICU Intensivist and Dr Parin Sangoi, Cardiologist were involved in this case.
Dr. Deorukhkar said, “Cardiac disease during pregnancy presents unique challenges due to physiological changes such as increased blood volume, heart rate, and cardiac output, essential for fetal development. Conditions like chronic hypertension, pulmonary hypertension, valvular heart disease, and congenital heart disease can be exacerbated by pregnancy, leading to severe complications.”
Dr. Sangoi said, “Peripartum Cardiomyopathy is a potentially life-threatening condition where the heart becomes enlarged and weakened, reducing its ability to pump blood effectively. Prompt diagnosis and treatment are crucial to improving outcomes.”
