Pregnancy and pulmonary arterial hypertension: A clinical conundrum
Publication Date
2015
Journal Title
Pregnancy Hypertens
Abstract
Pulmonary arterial hypertension (PAH) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance which eventually leads to right ventricular failure and death. PAH inflicts most commonly women, majority of who are of childbearing age. Pregnancy in the setting of PAH is absolutely contraindicated due to high maternal fetal morbidity and guidelines do not exist for the management of such cases. A MEDLINE/PubMed search was performed identifying all relevant articles with "pulmonary arterial hypertension'' and "pregnancy'' in the title. Six case series were reviewed as well as our own center's experience outlined. Though there exists generalized treatment measures that are followed in such cases, management varies among different national centers as well an on an international level. At our center patients are managed using a multidisciplinary approach at a high risk obstetric center with preference for intravenous prostacyclin therapy. Women of child bearing age with possible signs and symptoms of PAH must be promptly diagnosed and managed expectantly with an emphasis on maternal-fetal safety. (C) 2015 International Society for the Study of Hypertension in Pregnancy Published by Elsevier B.V. All rights reserved.
Volume Number
5
Issue Number
2
Pages
157-164
Document Type
Article
EPub Date
2015/05/07
Status
Faculty, Northwell Researcher
Facility
School of Medicine; Northwell Health
Primary Department
Pulmonary, Critical Care, and Sleep Medicine
Additional Departments
Obstetrics and Gynecology
PMID
DOI
10.1016/j.preghy.2015.01.004