Twin pregnancy in a patient with dilated cardiomyopathy
DOI:
https://doi.org/10.35954/SM2025.44.2.7.e503Keywords:
cardiomyopathy, dilated, pregnancy complications, cardiovascular, pregnancy, twin, myocardium /diagnostic imaging, stroke volumeAbstract
Introduction: There are few reports of women with dilated cardiomyopathy who have decided to become pregnant, as people with this condition are advised not to conceive. If this does happen, it must be carefully assessed by a multidisciplinary team due to the risk of cardiac failure, arrhythmias, and/or other complications that increase maternal and fetal morbidity and mortality.
Clinical case: We report the case of a 31-year-old patient with dilated cardiomyopathy, with a left ventricular ejection fraction of 38% on echocardiogram, who had a high-risk twin pregnancy.
Results: The pregnancy was terminated at 34 weeks, resulting in two newborns without pathologies and with good maternal evolution.
Discussion: Pregnant women with dilated cardiomyopathy and reduced left ventricular ejection fraction are at increased risk of complications such as heart failure, acute pulmonary edema, potentially dangerous arrhythmias, sudden death, premature delivery, and fetal death. In twin pregnancies, the risk is increased due to the greater increase in blood volume and the additional demand on the heart.
Conclusions: The assessment and monitoring of a pregnant patient with dilated cardiomyopathy should be carried out by a multidisciplinary team specializing in obstetrics and cardiology.
Note: This article was approved by the Editorial Committee.
Received for review: February 2025.
Accepted for publication: June 2025.
Correspondence: 8 de Octubre 3020, C.P. 11100. Tel.: (+598) 24876666 ext. 3330. Montevideo, Uruguay.
Contact email: anabelafm@telefonica.net
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Copyright (c) 2025 Anabela Fernández, Jorge Castelli, Ignacio Farro
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