Ascites in peripartum cardiomyopathy: case report

Abstract

Ascites is the abnormal accumulation of excess fluid in peritoneal cavity.1 Normally, peritoneal cavity contains 25–50 mL of ascitic fluid, which allows for the movement of bowel loops past one other and helps hydrate serousal surfaces. Cirrhosis is the most common cause of ascites in the Western world (75%), followed by peritoneal malignancy (12%), heart failure (5%) (include peripartum cardiomyopathy), and peritoneal tuberculosis (2%). A 19-years-old woman diagnosed with peripartum cardiomyopathy. She came with chest pain and increased of her abdominal perimeter since 6 month ago, a month after she got cesarean delivery. She was given high protein and low sodium diet, water restriction, treated with furosemide 40 mg, spironolactone 25 mg, and abdominal paracentesis with total 1500 cc of yellowish ascites fluid was evacuated. Early detection is required in this case to ensure effective management without any complications. Treatment depends upon the cause of the ascites. Dietary sodium restriction and diuretics remains the first line therapy for its management. The use of diuretics needs close monitoring and follow up, including weight loss, electrolytes, and patient’s condition daily.