Peripartum cardiomyopathy occurs toward the end or immediately after delivery and can result in systolic heart failure. The etiology remains unclear.
The risk of subsequent heart failure during a pregnancy following one that resulted in peripartum cardiomyopathy depends predominantly on whether the left ventricular systolic function normalized or remained depressed. In general, the data to answer this question are limited.
If the left ventricular systolic function returned to normal after the prior pregnancy, then the risk is low based on one case series reporting about 21% developing symptomatic heart failure.
If the left ventricular systolic function did not return to normal after the prior pregnancy, the mortality rate was 19% in one small case series with a large majority developing heart failure symptoms.
The current recommendation is to avoid pregnancy if the left ventricular systolic function remains depressed; however, it is safe to attempt future pregnancies if the systolic function returned to normal.