OPTIMIZATION OF INTENSIVE CARE IN CRITICAL CONDITIONS IN PATIENTS WITH PERIPARTUM CARDIOMYOPATHY
Keywords:
Keywords: peripartum cardiomyopathy, intensive care, ECMO, inotropes, bromocriptine, maternal mortality.Abstract
Abstract Peripartum cardiomyopathy (PPCM) is a rare but potentially fatal complication of pregnancy. The article analyzes modern strategies of intensive care in critical forms of PPCM. Pharmacological and non-pharmacological methods are described, including the use of bromocriptine, inotropes, and mechanical circulatory support devices (IABP, ECMO). Data from clinical studies and an algorithm for managing patients in the ICU are presented. The importance of a multidisciplinary approach is emphasized.
References
Mebazaa A, Tolppanen H, Mueller C, Lassus J, di Somma S, Baksyte G, et al. Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance. Intensive Care Med. 2016; 42(2): 147–63. doi: 10.1007/s00134-015-4041-5.
Sheppard R, Rajagopalan N, Safirstein J, Briller J. An update on treatments and outcomes in peripartum cardiomyopathy. Future Cardiol. 2014. 10(3), 435–47. doi:
10.2217/fca.14.23
Sliwa K, Damasceno A, Mayosi BM. Epidemiology and etiology of cardiomyopathy in Africa.Circulation. 2005;112:3577–83. doi: 10.1161/
CIRCULATIONAHA.105.542894.
Sliwa K, Hilfiker-Kleiner D, Petrie MC, Mebazaa A, Pieske B, Buchmann E, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from Heart Failure Association of European Society of Cardiology Working Group on peripartum cardiomyopathy. Eur J Heart Fail. 2010; 12(8): 767-78. doi: 10.1093/eurjhf/hfq120
Stapel B, Kohlhaas M, Ricke-Hoch M, Haghikia A, Erschow S, Knuuti J, et al. Low STAT3 expression sensitizes to toxic effects of β-adrenergic receptor stimulation in peripartum cardiomyopathy. Eur Heart J. 2016; ehw086. doi: 10.1093/eurheartj/ehw086.
Sliwa K, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy. Eur J Heart Fail, 2010; 12:767-778.
Fett JD. Viral infection as a possible trigger for peripartum cardiomyopathy. Int J Gynaecol Obstet, 2007; 97:149-150.
Mielniczuk LM, et al. Incidence of peripartum cardiomyopathy in the United States. J Am Coll Cardiol, 2006; 48:1657-1662.
Pierce J, et al. Peripartum cardiomyopathy. Am J Cardiol, 1963; 12:345-350.
Sliwa K, et al. EURObservational Research Programme: Peripartum cardiomyopathy registry. Eur Heart J, 2020; 41:3599-3606.
Likar.Info. Peripartum cardiomyopathy. 2013;
Compendium. Peripartum cardiomyopathy: Recent insights. Compendium, 2023;
Medicover Hospitals. Peripartum cardiomyopathy: Causes, symptoms, treatment. 2024;
Krasotaimedicina. Secondary cardiomyopathy. 2021;
Medelement. Peripartum cardiomyopathy: Clinical protocols. 2014; Available at: diseases.medelement.com.
IPAC Study. Prospective study on peripartum cardiomyopathy. 2013;
ESC Guidelines. Management of acute heart failure. Eur Heart J, 2021; 42:3599-3726.
ICH GCP. Molecular-genetic screening in peripartum cardiomyopathy. 2023; Available at: ichgcp.net.
