Incidence and long-term outcomes of pregnant women complicated with pulmonary arterial hypertension during different pregnancies: A prospective cohort study from China

Yang, Menghui; Wang, Jian; Zhang, Xueming; Zhuang, Qi; Wang, Ruomeng; Shen, Jieyan; Lin, Jianhua

doi:10.1016/j.ijcard.2020.10.021

Cited by 11 publications

(9 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, special attention must be paid to certain endothelin receptor antagonists and guanylate cyclase agonists (such as riociguat), which have teratogenic effects and must be avoided during pregnancy 43 44. Additionally, the comprehensive application of inotropic, diuretics, anti-infection, antiplatelets and anticoagulants, and oxygen therapies also has a positive effect on haemodynamic parameters and maternal outcomes 45 46…”

Section: Discussionmentioning

confidence: 99%

Impact of pregnancy in patients with systemic lupus erythematosus-associated pulmonary arterial hypertension: case series and literature review

Tian

Qian

et al. 2022

Lupus Sci Med

View full text Add to dashboard Cite

ObjectiveThis study aimed to investigate the clinical characteristics and outcomes of pregnancy complicated by SLE-associated pulmonary arterial hypertension (SLE-PAH) in a case series and literature review.MethodsThis single-centre retrospective study included 10 consecutive pregnancies complicated by SLE-PAH confirmed by right heart catheterisation (RHC) at Peking Union Medical College Hospital between 2009 and 2020. A literature search was conducted and 14 pregnancy cases complicated by SLE-PAH were reviewed.ResultsAt the time of 10 patients’ initial visits, the average age was 30.00±5.72 years and the median disease duration of SLE and PAH was 34.5 (range 1–164) months and 2 (1–51) months. Two patients carried planned pregnancy, seven patients developed PAH during pregnancy and one pregnancy was unplanned. Further, nine patients had low disease activity, with Systemic Lupus Erythematosus Disease Activity Index between 0 and 4, and 30%, 30% and 40% of patients were of WHO functional class II, III and IV, respectively. All patients were evaluated by RHC and echocardiography. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were elevated in 70% of patients, with a median level of 776 (56–18 023) pg/mL. The median time of completed pregnancies in all patients was 31 (15–38) weeks and six patients delivered live infants. SLE activity and PAH severity improved in 70% of patients within 6 months after delivery. One patient died on the 15th day after induction of labour. In the remaining patients, all achieved a lupus low disease activity state; according to the European Society of Cardiology/European Respiratory Society risk stratification, seven were categorised at a lower risk state compared with their risk stratification during pregnancy, and two remained at intermediate risk. Additionally, 80% of patients exhibited mild impairments with WHO functional class I or II. The median NT-proBNP level was 184 (32–4003) pg/mL within 6 months after delivery. In the reviewed literature, the average age of patients was 30.09±5.37 years. The median time of completed pregnancies was 36 (28–40) weeks. More cases were planned and successful, and the survival rates of mothers and neonates were 85.71% and 92.86%, respectively.ConclusionsSuccessful pregnancy could be possible in women with SLE-PAH if SLE-PAH treatment goals are achieved under proper therapies, careful monitoring and thorough evaluations.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of pregnancy in patients with systemic lupus erythematosus-associated pulmonary arterial hypertension: case series and literature review

Tian

Qian

et al. 2022

Lupus Sci Med

View full text Add to dashboard Cite

show abstract

“…The other diagnoses mentioned in the consensus document were not present in our study population. According to the severity of sPAP, patients with an sPAP of 36–49 mmHg had mild PH, those with an sPAP of 50–69 mmHg had moderate PH, and those with an sPAP ≥70 mmHg had severe PH [ 8 , 11 ].…”

Section: Methodsmentioning

confidence: 99%

“…In obstetrics, the sPAP is often indirectly evaluated by the tricuspid regurgitation pressure difference under cardiac colour Doppler ultrasound, and an sPAP ≥36 mmHg (1 mmHg = 0.133 kPa) is used as the diagnostic standard of PH [10]. In this study, the inclusion criteria were as follows: all subjects had undergone cardiac echocardiography, which met the diagnostic criteria of echocardiography, been transferred to the ICU for hemodynamic monitoring during the perinatal period, or had a clinical diagnosis of PH that was confirmed by right cardiac catheterization in the cardiovascular department after delivery [11]. The exclusion criteria were as follows: patients with an elevated sPAP caused by outflow tract obstruction/pulmonary stenosis.…”

Section: Diagnosis Inclusion and Exclusion Criteria Of Phmentioning

confidence: 99%

Pregnancy outcomes in women with pulmonary hypertension: a retrospective study in China

Huang

Liao

et al. 2023

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background In recent years, with the development of monitoring conditions and the application of pulmonary vascular-targeted drugs, pregnancy outcomes in women with pulmonary hypertension (PH) have improved, but the maternal mortality rate is still high. The purpose of this study was to describe the maternal-foetal outcomes in pregnant women with PH. Methods The clinical data of 154 pregnant women with PH who were admitted to the Third Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2020 were collected and descriptively analysed. Results Among the 154 pregnant women with PH, 6 (3.9%) had idiopathic pulmonary arterial hypertension (iPAH), 41 (26.6%) had pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH), 45 (29.2%) had PAH related to other diseases (oPAH), and 62 (40.3%) had PH related to left heart disease (LHD-PH). The systolic pulmonary artery pressure (sPAP) was 36–49 mmHg in 53.2% of the patients, 50–69 mmHg in 22.1% of the patients and ≥ 70 mmHg in 24.7% of the patients. Five (3.2%) pregnant women died within 1 week after delivery; iPAH patients had the highest mortality rate (3/6, 50%). Fifty-four patients (35.1%) were admitted to the intensive care unit (ICU), and the incidence of heart failure during pregnancy was 14.9%. A total of 70.1% of the patients underwent caesarean section; 42.9% had premature infants; 28.6% had low-birth-weight (LBW) infants; 13.0% had very-low-birth-weight (VLBW) infants; 3.2% had extremely-low-birth-weight (ELBW) infants; 61% had small for gestational age (SGA) infants; and 1.9% experienced neonatal mortality. Conclusion There were significant differences in the maternal-foetal outcomes in the iPAH, CHD-PAH, oPAH and LHD-PH groups. Maternal mortality was highest in the iPAH group; therefore, iPAH patients should be advised to prevent pregnancy. Standardized and multidiscipline-assisted maternal management is the key to improving maternal-foetal outcomes.

show abstract

“…In this study, the inclusion criteria were as follows: all subjects had undergone cardiac echocardiography, met the diagnostic criteria of echocardiography, had PH values determined according to the clinical diagnostic criteria, and had a PASP confirmed to be more than 35 mmHg by echocardiography. 11 , 12 , 13 The exclusion criterion was patients with elevated PASP caused by outflow tract obstruction/pulmonary stenosis.…”

Section: Methodsmentioning

confidence: 99%

Maternal and fetal/neonatal outcomes of pregnancies complicated by pulmonary hypertension: a retrospective study of 154 patients

Liao

et al. 2023

Clinics

View full text Add to dashboard Cite

Incidence and long-term outcomes of pregnant women complicated with pulmonary arterial hypertension during different pregnancies: A prospective cohort study from China

Cited by 11 publications

References 32 publications

Impact of pregnancy in patients with systemic lupus erythematosus-associated pulmonary arterial hypertension: case series and literature review

Impact of pregnancy in patients with systemic lupus erythematosus-associated pulmonary arterial hypertension: case series and literature review

Pregnancy outcomes in women with pulmonary hypertension: a retrospective study in China

Maternal and fetal/neonatal outcomes of pregnancies complicated by pulmonary hypertension: a retrospective study of 154 patients

Contact Info

Product

Resources

About