Eisenmenger Pregnancy Mortality Index (EPMI) Calculator

Eisenmenger Pregnancy Mortality Index (EPMI): Explanation and Clinical Context
The Eisenmenger Pregnancy Mortality Index (EPMI) is a validated tool designed to estimate the risk of maternal mortality in pregnant women with Eisenmenger syndrome. It incorporates simple clinical and laboratory parameters readily available in routine care: NYHA functional class, oxygen saturation, hemoglobin level, and platelet count. Each variable contributes to a cumulative score that stratifies women into low, moderate, or high maternal risk categories.

NYHA functional class III–IV reflects severe functional limitation and carries significant risk. Oxygen saturation <85% indicates profound hypoxemia, increasing the likelihood of complications. Hemoglobin >20 g/dL suggests chronic hypoxemia with secondary erythrocytosis, and platelet count <100 x10^9/L reflects coagulopathy risk.

This tool helps clinicians counsel patients, optimize monitoring strategies, and plan peripartum management in high-risk pregnancies.

Reference:
Opotowsky AR, Siddiqi OK, Webb GD, et al. Predictors of Mortality in Pregnant Women With Eisenmenger Syndrome. Circulation. 2012;125:123-129. doi:10.1161/CIRCULATIONAHA.111.038105

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