LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Toby Gish <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 20 Mar 1996 17:34:10 PST
Content-Type:
text/plain
Parts/Attachments:
text/plain (44 lines)
"Peripartum cardiomyopathy is defined as cardiomyopathy developing in the
last month of pregnasncy or the first 6 months postpartum in a woman
without previous disease and after exclusion of other causes of cardiac
failure. It is therefore a diagnosis of exclusion that should not be made
without a concerted effort to identitfy valvular, metabolic, infectious,
or toxic causes of cardiomyopathy............. The incidence of
peripartum cardiomyopathy is estimated at betweeen one in 1500 and one in
4000 deliveries in the US. An incidence as high as 1% has been suggested
in women of certain African tribes. However, idiopathic heart failure in
these women may be primarily a result of ujnnusual culturally mandated
peripartum custums involving excessive sodium intake and may represent as,
as such, simple fluid overload. (interesting!) In the US, the peak
incidence of peripartum cardiomyopathy occurs in the second postpartum
month and appears most frequently among older, multiparous black females.
Other suggested risk factors include twinning and pregnancy-induced
hypertensiln.In some cases, a familial recurrence pattern has been
reported. The condition is manifest clinically by  increasing fatigue,
dyspnea (shortness of breath), and peripheral or pulmonary edema. Physical examination reveals
classic evidence of congestive haeart failure. including jugular venous distentioon. rales, and
an S2 gallop. Cardiomegaly and pulmonary edema are found on chest x-ray, and the
electrocardiogran............Overall mortality ranges from 25% to 50%.........Because of the
nonspecific clinical and pathologic nature of perpartum cardiomypathy, it's existance as a
distinct entiry is supported primarily by epidemiologic evidence suggesting that 80% of cases of
idiopathic cardiomyopathy in women of chicldbearing age occur in the perpartum period. Such aN
epidemio;ogical distribution could also bbe attributed to an exacerbation of underlying
subclinical cardiac disease related to the hemodynamic changes accompaning normal pregnancy.
However, as such changes are maximal in the third trimest of pregnancy and return to normal
within a few weeks postpartum, such a pattern does not explain the peak incidence of pc
occurring, in most reports, during the second month postpartum ...........Although nutritional,
hormonal , and auto immune etiologies all have been sugggest, substantial backing for any of
these theories is lacking........Therapy includes digitalization, diuretics, sodium restriction,
and prolonged bedrest......
Tends to recur with subsequent pregnancies.....prognosis for future pregnancies related to heart
size.....Taken from:Reece,E. Hobbins,J,Mahoney, M, Petrie,H. MEDICINE OF THE FETUS & MOTHER.
1992. J.B> Lippincott Company. Philadelphia. HOpe this helps- Toby
-------------------------------------
Name: Toby Gish R.N.LLLL.IBCLC
E-mail: Toby Gish <[log in to unmask]>
Date: 20/03/96
Time: 03:19:19 PM

This message was sent by Chameleon
-------------------------------------

ATOM RSS1 RSS2