Zusammenfassung
Der Fallbericht beschreibt Diagnose, Therapie sowie den mütterlichen und den fetalen
Verlauf einer akut verlaufenden peripartalen Kardiomyopathie (PPCM). Bei einer 36-jährigen
Schwangeren ohne vorbestehende Herzkrankheit kam es sub partu zu einem Lungenödem.
Eine fetale Bradykardie und die respiratorische Insuffizienz der Mutter zwangen zur
sofortigen Entbindung. Der Artikel demonstriert klinische und echokardiographische
Kriterien zur Diagnostik dieser seltenen Erkrankung. Anhand der verfügbaren Literatur
werden mögliche Ursachen, klinisches Management und die Langzeitprognose diskutiert,
da zukünftige Schwangerschaften mit einem mindestens 50 %igen Rezidivrisiko verbunden
sind.
Abstract
This case report describes the diagnosis, treatment as well as maternal and fetal
outcome of a pregnancy complicated by peripartum cardiomyopathy (PPCM). The article
demonstrates criteria that define peripartum cardiomyopathy using clinical and echocardiographic
features. In absence of preexisting heart disease an acute left ventricular dysfunction
of the mother led to fetal bradycardia and immediate delivery. We discuss possible
causes, clinical management and long term outcome in respect of the available literature.
Future pregnancies should be avoided with at least 50 % risk of recurrence.
Schlüsselwörter
peripartale Kardiomyopathie - Schwangerschaft
Key words
Peripartum cardiomyopathy - pregnancy
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Prof. Dr. M. Butterwegge
Chefarzt der Klinik für Gynäkologie und Geburtshilfe am Marienhospital Osnabrück
Johannisfreiheit 2-4
49074 Osnabrück
Phone: 05 41/3 62-42 02
Fax: 05 41/3 26-42 27
Email: butterwegge@firemail.de