[I-P02-1-08] 本邦の周産期心筋症における死亡例と救命例の比較の為のスコアリングの探求
Keywords:pregnancy, cardiomyopathy, maternal death
[Objectives] Peripartum cardiomyopathy is a major cause of death among expectant and nursing mothers, but there are no evidence-based guidelines for team-based treatment approaches. The aim of this study is to evaluate the impact of disease recognition and interactions among medical staff in fatal and survival cases of peripartum cardiomyopathy.[Methods] The study was performed as a retrospective analysis of 8 fatal cases (from 2010 to 2021) and 8 survival cases (from 2020 to 2021) of expectant and nursing mothers with peripartum cardiomyopathy reported to Maternal Death Exploratory Committee in Japan. Five items were evaluated in each case on a 3-point scale (0, 1 and 2 points): Perception (period of onset of respiratory symptoms), 2. Diagnosis (peripartum cardiomyopathy included in differential diagnosis), 3. Link to Obstetrics (was the condition linked to obstetrics), 4. Team Medicine (cooperation with internal medicine and other departments), and 5. Severity (severity of disease).[Results] The total scores for the 8 survival cases vs. the 8 fatal cases were Perception (10 vs. 8), Diagnosis (10 vs. 6), Link to Obstetrics (8 vs. 6), Team Medicine (12 vs. 7), and Severity (8 vs. 16).[Conclusio The scores for survival cases of peripartum cardiomyopathy were higher than those for survival cases for Diagnosis, Team Medicine, and Severity. These findings suggest that treatment of peripartum cardiomyopathy should involve a combination of physicians with expertise in obstetrics and gynecology and cardiovascular medicine.