Pulmonary Hypertension and Pregnancy

Gei, Alfredo F.; Montúfar-Rueda, Carlos

doi:10.1097/grf.0000000000000076

Cited by 18 publications

(11 citation statements)

References 70 publications

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“…3,4 For women with PH, deterioration of cardiac function resulting from hemodynamic changes is dramatic following delivery. 3,4 These women are likely to suffer from acute pulmonary and cardiac failure with the progression of pregnancy, which can result in both maternal and fetal mortality. Indeed, the mortality rate in pregnant women with PH was reported to be as high as 60%.…”

Section: Introductionmentioning

confidence: 99%

Long‐term outcomes of pregnant women with pulmonary hypertension diagnosed by echocardiography: a retrospective cohort study in a single center from China

2021

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Recent studies suggest that pregnancy may not be absolutely contraindicated in women with moderate pulmonary hypertension. We aimed to evaluate the long-term outcomes of pregnant women with pulmonary hypertension diagnosed by echocardiography in our clinical department. Pregnant women with pulmonary hypertension, diagnosed by a pulmonary systolic arterial pressure > 30 mmHg via echocardiography, who were admitted in our department for termination of pregnancy or delivery between 2004 and 2016 were included in this retrospective cohort study. Demographic characteristics, clinical histories, perinatal outcomes, and follow-up outcomes after discharge were reported. The primary outcome was survival of the pregnant women after discharge. A total of 88 pregnant women with pulmonary hypertension were included in this cohort study. The women were categorized into severe and moderate pulmonary hypertension groups according to their pulmonary systolic arterial pressure at admission. Women with severe pulmonary hypertension were significantly more likely to have deteriorated cardiac function and higher incidence of neonatal complications during the perinatal periods (p < 0.05). During a median follow-up of 26 months, the mortality rate was significantly higher in women with severe pulmonary hypertension (p < 0.05). However, the accumulated survival rate was >90% for women with moderate pulmonary hypertension within the follow-up period. Multivariate Cox regression analyses showed that poor cardiac function before pregnancy, irregular antenatal care, and hyperuricemia were independent mortality risk factors for women with pulmonary hypertension after discharge. In conclusion, the long-term survival of pregnant women with moderate pulmonary hypertension diagnosed by echocardiography was considered acceptable in this cohort. Our findings suggest that pregnancy might not be absolutely contraindicated in women with moderate pulmonary hypertension.

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Section: Introductionmentioning

confidence: 99%

Long‐term outcomes of pregnant women with pulmonary hypertension diagnosed by echocardiography: a retrospective cohort study in a single center from China

2021

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“…Besides that, the increased circulating blood volume causes the increase in pulmonary flow leading, during the first gestational trimester, to pregnancy physiological dyspnea (30) . Along with increased cardiac output due to pregnancy, the increased blood volume takes to an overload of the circulatory system, leading to increased pulmonary artery pressure (32)(33) .…”

Section: Discussionmentioning

confidence: 99%

Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women

et al. 2020

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Objective: To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women. Method: The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory. Results: We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them. Conclusion: The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.

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“…This places added stress on the already compromised cardiopulmonary system in PAH. The resultant right ventricular failure and cardiovascular collapse are the primary causes of high mortality in gravid patients with PAH [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Use of Extracorporeal Membrane Oxygenation in Postpartum Management of a Patient with Pulmonary Arterial Hypertension

Memon

Safdar

Goodarzi

2018

Case Reports in Pulmonology

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Current guidelines do not recommend pregnancy in patients with pulmonary arterial hypertension (PAH). This is due to the associated high mortality, which both dissuades PAH patients from becoming pregnant and encourages termination of pregnancy due to high maternal mortality risk. As a result, there is a lack of data and, consequently, there are only general guidelines available for management of pregnancy in PAH patients. Additionally, novel therapeutic strategies such as extracorporeal membrane oxygenation (ECMO), although used in the management of nonpregnant PAH patients as a bridge to lung transplantation, have not been used to treat cardiopulmonary collapse in pregnant PAH patients. In an attempt to bridge this paucity of data, we report the successful use of ECMO in resuscitation and management of a pregnant PAH patient who experienced cardiopulmonary collapse following a caesarian section.

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Pulmonary Hypertension and Pregnancy

Cited by 18 publications

References 70 publications

Long‐term outcomes of pregnant women with pulmonary hypertension diagnosed by echocardiography: a retrospective cohort study in a single center from China

Long‐term outcomes of pregnant women with pulmonary hypertension diagnosed by echocardiography: a retrospective cohort study in a single center from China

Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women

Use of Extracorporeal Membrane Oxygenation in Postpartum Management of a Patient with Pulmonary Arterial Hypertension

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