Personal commentary: monitoring subsequent pregnancy in recovered peripartum cardiomyopathy mothers.

Peripartum cardiomyopathy (PPCM) is defined as the first appearance of systolic heart failure in a previously healthy woman during the last month of pregnancy or up to 6 months postpartum. Both planned and unplanned pregnancies may occur in recovered and non-recovered PPCM mothers, requiring careful counseling and management strategies. Previous studies indicate that relapse of heart failure in post-PPCM pregnancies is always a possibility, even in recovered PPCM mothers. The risk of relapse is high when the left ventricular ejection fraction is less than 0.50, and should be considered a relative contraindication to subsequent pregnancy. There are not yet established protocols for monitoring subsequent pregnancies in those who once had PPCM, and few medical articles with guidelines. This personal commentary contains parameters that have been found useful to contribute to safer monitoring with improved outcomes.