Multisystem Complication in Pregnancy: A Case Report of PPCM, SN and RHD

Abstract

Pregnancy can trigger cardiovascular and renal complications, such as peripartum cardiomyopathy (PPCM), nephrotic syndrome (NS), and rheumatic heart disease (RHD), which increase the risk for the mother and fetus. PPCM occurs due to heart failure in late pregnancy or postpartum, while NS is characterized by proteinuria and edema. RHD can worsen this condition, especially in the presence of mitral stenosis.

Objective: This case report aims to describe clinical presentation and management of complications in pregnancy.

Case report: A 37-year-old woman, G2P1, 33 weeks gestation came with complaints of abdominal tightness and shortness of breath. Complaints were accompanied by fever, weakness, and swelling in the lower legs. Examination found high blood pressure and proteinuria. While heart enlargement and mitral stenosis were found from echocardiography. Obstetric examination showed a baby with a heart rate of 117 bpm and the fetal head had not entered the upper pelvic inlet.

Conclusion: Management of pregnancy with complications such as peripartum cardiomyopathy (PPCM), nephrotic syndrome (NS), and rheumatic heart disease (RHD) requires a strict multidisciplinary approach. Monitoring of cardiovascular and renal function is essential to prevent further complications.