Peripartum cardiomyopathy: a comprehensive review.

The objective of this article is to review the etiology, diagnosis, treatment, prognosis, and natural history of peripartum cardiomyopathy. The English language medical literature was accessed though MEDLINE from 1966 to the present; additional sources were obtained by cross-referencing. Because of the limited number of studies and patients, metaanalysis could not be performed; however, the existing data regarding the etiology, diagnosis, treatment, and prognosis of peripartum cardiomyopathy are presented. Approximately 1000 U.S. women will have peripartum cardiomyopathy this year, and for many it will be fatal. The etiology of this disease remains uncertain, but current evidence suggests myocarditis of viral, autoimmune, or idiopathic origin. The utility of immunosuppressive therapy remains ambiguous; however, other advances in medical therapy for dilated cardiomyopathy and cardiac transplantation have significantly improved quality of life and survival for patients. As the initial patient contact, obstetricians and family practitioners must recognize this malady early and rapidly institute the proper medical therapy directed toward the congestive state.