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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