Primary Pulmonary Hypertension in Pregnancy

Wong, P S C; Constantinides, S; Kanellopoulos, V.; Kennedy, Colin; Watson, David; Shiu, M F

doi:10.1177/014107680109401010

Cited by 21 publications

(15 citation statements)

References 6 publications

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“…Postoperative increases in peripheral vascular resistance occur and may contribute to post-partum mortality. 21 Although there may be less alteration to hemodynamic parameters with regional anesthesia, good outcomes have been reported with both regional and general anesthesia [1][2][3][4][22][23][24] Little has been written about the effects of epoprostenol on the intrauterine environment. In our case, intensive fetal surveillance during intravenous epoprostenol therapy failed to show fetal harm.…”

Section: Discussionmentioning

confidence: 99%

Epoprostenol treatment for idiopathic pulmonary arterial hypertension in pregnancy

et al. 2010

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Idiopathic pulmonary arterial hypertension is a rare condition associated with significant maternal mortality. We report the management of a 37-year-old multigravida with severe disease using epoprostenol, a multidisciplinary approach, and a planned delivery. Although the patient survived the pregnancy, her pulmonary function significantly worsened. Epoprostenol, a pulmonary vasodilator, should be considered when indicated during pregnancy. Neither fetal nor neonatal harm was identified.

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Section: Discussionmentioning

confidence: 99%

Epoprostenol treatment for idiopathic pulmonary arterial hypertension in pregnancy

et al. 2010

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“…In patients with primary pulmonary hypertension, PGI2 acutely decreases pulmonary vascular resistance, increases cardiac output and increases systemic oxygen delivery. 17,20,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Elliot et al 30 used nebulized iloprost therapy as early as 8 weeks in pregnancy, with pregnancies completed between 25 and 36 weeks, and with deliveries by caesarean section under local anesthesia without maternal or infant mortality or congenital abnormalities. In patients with congenital heart disease and PAH who failed conventional therapy, long-term, continuous intravenous PGI2 reduced pulmonary artery pressures by 21%, improved cardiac index (69%), pulmonary vascular resistance (52%), and New York Heart Association functional class, but not 6-minute walk distance.…”

Section: Prostacyclin Pathwaymentioning

confidence: 99%

Pulmonary Hypertension in Pregnancy

Martínez

Rutherford

2013

Cardiology in Review

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The presence of pulmonary arterial hypertension (PAH) in pregnancy is rare and signifies a high-risk pregnancy. Although the majority of mothers have knowledge of their condition before pregnancy, approximately one-third of patients are diagnosed during pregnancy. Termination of pregnancy should be discussed, and is often advised; however, a significant proportion of patients will choose to proceed with the pregnancy despite increased maternal and fetal mortality. Currently, most pregnant patients receive advanced therapy for treatment of PAH, particularly prostacyclin analogues. Particular attention is paid to volume status and blood loss and there has been a major trend toward delivery by cesarean section under controlled conditions involving an expert multidisciplinary team. The time of greatest maternal risk is in the first month after delivery. Transplantation of these patients in the nonpregnant state may be considered when those with idiopathic pulmonary hypertension have poor functional status despite optimal therapy and their projected 2-year survival is less than 50%. For patients with Eisenmenger syndrome, severe symptoms and an unacceptable quality of life may lead to transplantation.

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“…Most authors reported positive outcomes with the use of epoprostenol [16][17][18][19][20]. Less data is available for nitric oxide [21], sildenafil [22,23], iloprost [24], and nebulized iloprost combined with epoprostenol [16,25]. A recent study has shown that 52% of pregnant women with CHD-PAH received PAH-specific therapy [7].…”

Section: Specific Therapies For Pulmonary Arterial Hypertension In Prmentioning

confidence: 99%

Pregnant woman with Eisenmenger’s syndrome (RCD code: VII-II-1A.4d)

Kopeć¹,

Leśniak‐Sobelga²,

Kaźnica-Wiatr³

et al. 2013

Journal of Rare Cardiovascular Diseases

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Pregnancy in women with pulmonary arterial hypertension due to congenital heart disease is associated with significant morbidity and mortality both in the mother and fetus. We report a case of a 25-year-old woman with Eisenmenger's syndrome who got pregnant when treated with bosentan. Bosentan was changed to sildenafil. During the course of pregnancy she developed ischemic stroke. She delivered in the 33 week of gestation. We present our treatment approach and review the current literature on pregnany in pulmonary arterial hypertension. JRCD 2013; 1 (3): 113-117

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Primary Pulmonary Hypertension in Pregnancy

Cited by 21 publications

References 6 publications

Epoprostenol treatment for idiopathic pulmonary arterial hypertension in pregnancy

Epoprostenol treatment for idiopathic pulmonary arterial hypertension in pregnancy

Pulmonary Hypertension in Pregnancy

Pregnant woman with Eisenmenger’s syndrome (RCD code: VII-II-1A.4d)

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