Peripartum cardiomyopathy, heart failure develops in the women without history of heart disorder, in an echocardiography, shows cardiomegaly and reduced LVEF, there is the case leading to maternal death. Our case was a 29 year-old pregnant woman without any history of heart failure. This was her first pregnancy and delivery. On 29th pregnancy week, she underwent fetoscopic laser surgery for twin-twin transfusion syndrome. She was hospitalized by threatened premature delivery on 35th pregnancy week. On 5th hospital day, she suddenly developed dyspnea and desaturated. Chest X ray detected cardiomegaly with severe pulmonary edema. She was diagnosed with acute heart failure and underwent an urgent cesarean section, by which the baby was delivered alive. However, during the operation, cardiopulmonary resuscitation was performed as she suffered cardiopulmonary arrest. In ICU, blood test showed BNP 626.8 pg/mL and TnI 184 ng/mL. UCG detected diffuse severe LV hypokinesis (LVEF 20%). After ROSC was confirmed with stable hemodynamic condition, TTM was conducted. We used an anti-prolactin agent in combination with standard heart failure therapy and LVEF was gradually improved. She left an ICU on 8th hospital day with symptom free from heart failure and without any neurological sequelae.
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