Multidisciplinary Management of Maternal Near Miss (MNM) due to Peripartum Cardiomyopathy � A Case Report

A Maternal Near Miss (MNM) case is defined by WHO as a woman who nearly died but survived a complication that occurred during pregnancy, child birth or within 42 days of termination pregnancy. Peripartum Cardiomyopathy (PPCM) is a rare type of idiopathic heart failure of unknown etiology that occurs in late pregnancy or 5 months postpartum with significant morbidity & mortality with an incidence of 2/3 cases in post-partum period. The hyperdynamic circulatory state of normal pregnancy can camouflage the heart failure. The case discussed here is a 32 year-old, G4P2L2A1, at 32 weeks of gestation with Type 2 Diabetes Mellitus (T2DM) & Hypertensive Disorders of Pregnancy (HDP) with previous 2 LSCS, presented to Emergency Room (ER) of Multispeciality Hospital with sudden onset of Shortness of Breath (SOB) with otherwise uneventful ante-natal period. She was put on elective ventilation due to persistent desaturation with Bilevel positive Airway pressure (BiPAP). FHS was localized. Echocardiography revealed severe generalized Left Ventricular (LV) wall hypokinesia, extreme tachycardia and LVEF(Ejection Fraction) of 30%. Mother crashed in ICU, ACLS was followed by LSCS. Next day, she was extubated successfully and gradually weaned from Medical Intensive Care Unit (MICU) to Maternity ward in a week. Neonates Septic Screen was positive. Excellent Neonatological care brought the neonate to oral feeds on D10. Mother & Neonate were discharged on D20. This is a unique MNM as both mother & baby were salvaged at 32 weeks of gestation with PPCM despite the crash in MICU.

Keywords

Maternal Near Miss, Peripartum Cardiomyopathy, Neonates Septic Screen, Left Ventricular Wall Hypokinesia

Citation

Bhattacharyya Nandini Chakrabarti, Roy Abhishek, Haldar Ritwik Ghosh, Chatterjee Sharmistha, Mandal Debanjan, Haque Sovana, Bhattacharyya Subhayan . Multidisciplinary Management of Maternal Near Miss (MNM) due to Peripartum Cardiomyopathy � A Case Report. Journal of the Indian Medical Association. 2024 May; 122(5): 65-67

URI

https://imsear.searo.who.int/handle/123456789/238867

Collections

Journal of the Indian Medical Association

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