Two primigravidae, 33 and 30 years of age, were admitted for pre-eclampsia after 41 and 32 weeks ofamenorrhoea, respectively. Both complained of dyspnoea that turned out to be due to heart failure. The foetuses both died before birth, but the women recovered following intensive care. Peripartum cardiomyopathy is a relatively rare but serious disease that usually develops during the last month of pregnancy or the first five months after delivery. Adequate diagnosis and treatment of pregnant women with signs of heart failure can prevent much suffering on the part of both mother and child. Because peripartum cardiomyopathy is diagnosed by exclusion, other causes of heart failure should first be ruled out. The subsequent preconceptional advice will depend on the recovery of cardiac function. Women with residual myocardial dysfunction run a severe risk of aggravated heart failure and should be strongly advised against becoming pregnant again.