Pregnancy in Pulmonary Arterial Hypertension

Overview

Journal Eur Respir Rev

Specialty Pulmonary Medicine

Date 2016 Dec 2

PMID 27903665

Citations 51

Authors

Karen M Olsson

Richard Channick

Affiliations

Soon will be listed here.

Abstract

Despite advanced therapies, maternal mortality in women with pulmonary arterial hypertension (PAH) remains high in pregnancy and is especially high during the post-partum period. However, recent data indicates that morbidity and mortality during pregnancy and after birth have improved for PAH patients. The current European Society of Cardiology/European Respiratory Society guidelines recommend that women with PAH should not become pregnant. Therefore, the risks associated with pregnancy must be emphasised and counselling offered to women at the time of PAH diagnosis and to women with PAH who become pregnant. Early termination should be discussed. Women who choose to continue with their pregnancy should be treated at specialised pulmonary hypertension centres with experience in managing PAH during and after pregnancy.

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References

Weiss B, Maggiorini M, Jenni R, Lauper U, Popov V, Bombeli T . Pregnant patient with primary pulmonary hypertension: inhaled pulmonary vasodilators and epidural anesthesia for cesarean delivery. Anesthesiology. 2001; 92(4):1191-4. DOI: 10.1097/00000542-200004000-00039. View

Lacassie H, Germain A, Valdes G, Fernandez M, Allamand F, Lopez H . Management of Eisenmenger syndrome in pregnancy with sildenafil and L-arginine. Obstet Gynecol. 2004; 103(5 Pt 2):1118-20. DOI: 10.1097/01.AOG.0000125148.82698.65. View

Satoh H, Masuda Y, Izuta S, Yaku H, Obara H . Pregnant patient with primary pulmonary hypertension: general anesthesia and extracorporeal membrane oxygenation support for termination of pregnancy. Anesthesiology. 2002; 97(6):1638-40. DOI: 10.1097/00000542-200212000-00045. View

Gleicher N, Midwall J, Hochberger D, JAFFIN H . Eisenmenger's syndrome and pregnancy. Obstet Gynecol Surv. 1979; 34(10):721-41. DOI: 10.1097/00006254-197910000-00001. View

Terek D, Kayikcioglu M, Kultursay H, Ergenoglu M, Yalaz M, Musayev O . Pulmonary arterial hypertension and pregnancy. J Res Med Sci. 2013; 18(1):73-6. PMC: 3719233. View

Bildirici I, Shumway J . Intravenous and inhaled epoprostenol for primary pulmonary hypertension during pregnancy and delivery. Obstet Gynecol. 2004; 103(5 Pt 2):1102-5. DOI: 10.1097/01.AOG.0000121826.75294.39. View

Yamaguchi E, Cardoso M, Torres M . [Oxytocin in cesarean sections: what is the best way to use it?]. Rev Bras Anestesiol. 2009; 57(3):324-50. DOI: 10.1590/s0034-70942007000300011. View

Regitz-Zagrosek V, Blomstrom Lundqvist C, Borghi C, Cifkova R, Ferreira R, Foidart J . ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2011; 32(24):3147-97. DOI: 10.1093/eurheartj/ehr218. View

Warnes C . Pregnancy and pulmonary hypertension. Int J Cardiol. 2004; 97 Suppl 1:11-3. DOI: 10.1016/j.ijcard.2004.08.004. View

10.

Avdalovic M, Sandrock C, Hoso A, Allen R, Albertson T . Epoprostenol in pregnant patients with secondary pulmonary hypertension: two case reports and a review of the literature. Treat Respir Med. 2004; 3(1):29-34. DOI: 10.2165/00151829-200403010-00004. View

11.

Bedard E, Dimopoulos K, Gatzoulis M . Has there been any progress made on pregnancy outcomes among women with pulmonary arterial hypertension?. Eur Heart J. 2009; 30(3):256-65. DOI: 10.1093/eurheartj/ehn597. View

12.

Wylie B, Epps K, Gaddipati S, Waksmonski C . Correlation of transthoracic echocardiography and right heart catheterization in pregnancy. J Perinat Med. 2007; 35(6):497-502. DOI: 10.1515/JPM.2007.133. View

13.

Bonnin M, Mercier F, Sitbon O, Roger-Christoph S, Jais X, Humbert M . Severe pulmonary hypertension during pregnancy: mode of delivery and anesthetic management of 15 consecutive cases. Anesthesiology. 2005; 102(6):1133-7. DOI: 10.1097/00000542-200506000-00012. View

14.

Thorne S, Nelson-Piercy C, MacGregor A, Gibbs S, Crowhurst J, Panay N . Pregnancy and contraception in heart disease and pulmonary arterial hypertension. J Fam Plann Reprod Health Care. 2006; 32(2):75-81. DOI: 10.1783/147118906776276486. View

15.

Mantha S, Karp R, Raghavan V, Terrin N, Bauer K, Zwicker J . Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis. BMJ. 2012; 345:e4944. PMC: 3413580. DOI: 10.1136/bmj.e4944. View

16.

Weiss B, Zemp L, Seifert B, Hess O . Outcome of pulmonary vascular disease in pregnancy: a systematic overview from 1978 through 1996. J Am Coll Cardiol. 1998; 31(7):1650-7. DOI: 10.1016/s0735-1097(98)00162-4. View

17.

Liu S, Liston R, Joseph K, Heaman M, Sauve R, Kramer M . Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. CMAJ. 2007; 176(4):455-60. PMC: 1800583. DOI: 10.1503/cmaj.060870. View

18.

Kiely D, Condliffe R, Webster V, Mills G, Wrench I, Gandhi S . Improved survival in pregnancy and pulmonary hypertension using a multiprofessional approach. BJOG. 2010; 117(5):565-74. DOI: 10.1111/j.1471-0528.2009.02492.x. View

19.

Bassily-Marcus A, Yuan C, Oropello J, Manasia A, Kohli-Seth R, Benjamin E . Pulmonary hypertension in pregnancy: critical care management. Pulm Med. 2012; 2012:709407. PMC: 3399488. DOI: 10.1155/2012/709407. View

20.

Stewart R, Tuazon D, Olson G, DUARTE A . Pregnancy and primary pulmonary hypertension : successful outcome with epoprostenol therapy. Chest. 2001; 119(3):973-5. DOI: 10.1378/chest.119.3.973. View