Peripartum Cardiomyopathy in a Woman Who Conceived Shortly After Bariatric Surgery: A Case Report.

摘要

Peripartum cardiomyopathy (PPCM) is a rare but potentially fatal form of heart failure occurring in the peripartum period without an identifiable cause. We report the case of a 36-year-old woman who conceived 2 months after bariatric surgery (BS). At 37 weeks of gestation, she underwent cesarean delivery and developed acute respiratory failure and seizures immediately after extubation. Further evaluation was performed to exclude other acute obstetric and cardiopulmonary conditions, including pulmonary embolism, and transthoracic echocardiography revealed global left ventricular hypokinesia with a left ventricular ejection fraction (LVEF) of 30%. Serial follow-up demonstrated a characteristic recovery pattern, with LVEF improving to 45% on postpartum Day 8 and to 55% at 12 weeks postpartum, supporting the diagnosis of PPCM. BS results in substantial hemodynamic, metabolic, and nutritional changes that require time for maternal adaptation, and pregnancy during this early postoperative period may impose additional cardiovascular stress. Although previous studies suggest that BS may reduce the long-term risk of PPCM, this potential benefit may not extend to pregnancies occurring shortly after surgery. This case highlights the importance of effective contraception, preconception counseling, and careful cardiovascular monitoring in women who conceive during the early period after BS.