Pulmonary hypertension and pregnancy outcomes: data from the Registry Of Pregnancy and Cardiac Disease (<scp>ROPAC</scp>) of the European Society of Cardiology

Sliwa, Karen; Hagen, Iris M. van; Budts, Werner; Swan, Lorna; Sinagra, Gianfranco; Caruana, Maryanne; Blanco, Manuel Vázquez; Wagenaar, Lodewijk J.; Johnson, Mark R.; Webb, Gary D.; Hall, Roger; Roos‐Hesselink, Jolien W.

doi:10.1002/ejhf.594

Cited by 198 publications

(223 citation statements)

References 21 publications

Supporting

Mentioning

193

Contrasting

Unclassified

Order By: Relevance

“…3,9,13 Continuous-wave Doppler TR jet velocity was used to determine systolic pulmonary artery pressure (SPAP or RVSP) using the simplified Bernoulli equation assigning a value of 8 or 15 mmHg to account for right atrial pressure considering the inferior vena cava diameter. This hospital provides tertiary care, mainly to the rural population in the south-eastern region of India and has 15 000-16 000 deliveries per year.…”

Section: Methodsmentioning

confidence: 99%

“…4 Women with PH tolerate haemodynamic changes of pregnancy poorly, which results in deterioration leading to maternal/fetal demise. [5][6][7][8][9][10][11][12] Advances in medical care have led to an increase in the life expectancy of patients with PH. [5][6][7] There is an increased risk of preterm birth and fetal growth restriction, in addition to increased risk of perinatal mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Mortality rates reported in the literature vary between 30 and 56%. [8][9][10][11][12] We conducted a case note review to assess the maternal and fetal outcomes of pregnant women with PH attending for care at a tertiary centre in south India. [5][6][7][8][9][10][11][12] Advances in medical care have led to an increase in the life expectancy of patients with PH.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcome of pregnancies in women with pulmonary hypertension: a single‐centre experience from South India

Keepanasseril

Pillai

Yavanasuriya

et al. 2019

BJOG

View full text Add to dashboard Cite

Objective To study maternal complications and pregnancy outcome in women with pulmonary hypertension, attending a tertiary centre in south India.Study design Retrospective observational study.Setting Tertiary centre in south India.Population Pregnant women with pulmonary hypertension.Method Data regarding demographics, clinical course, medication received, and echocardiographic diagnosis regarding pulmonary hypertension and antenatal care received were collected from the records. Details of labour and delivery, and postpartum follow up were retrieved. We compared the outcome based on the presence or absence of cyanosis and right ventricular systolic pressure levels.Main outcome measures Maternal mortality, occurrence of complications such as heart failure, fetal growth restriction.Results There were 81 pregnancies in 73 women with pulmonary hypertension. The majority of them had pulmonary hypertension secondary to congenital heart disease (80.8%); 17.8% had Eisenmenger syndrome. An advanced pulmonary artery hypertension (PAH) medication, sildenafil, was administered in 25 (31.3%) pregnancies. There were four maternal deaths, of which three had Eisenmenger syndrome. Heart failure complicated 6.3% and fetal growth restriction 26.3% of pregnancies. Morbidity was significantly increased in women with pulmonary hypertension associated with a cyanotic cardiac lesion or with right ventricular systolic pressure >70 mmHg.Conclusion Despite advances in care, mortality in pregnant women with pulmonary hypertension is a matter of concern, especially in those with Eisenmenger syndrome. Multidisciplinary team management in tertiary centres and the use of advanced PAH medications even in low-to middle-income countries with limited resources, could lead to a reduction in morbidity and mortality related to pulmonary hypertension.Keywords Eisenmenger syndrome, pregnancy, pulmonary hypertension.Tweetable abstract Multidisciplinary care and use of new medication may improve outcomes in pregnant women with pulmonary hypertension.Please cite this paper as: Keepanasseril A, Pillai AA, Yavanasuriya J, Raj A, Satheesh S, Kundra P. Outcome of pregnancies in women with pulmonary hypertension: a single-centre experience from South India. BJOG 2019; 126 (S4): 43-49.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome of pregnancies in women with pulmonary hypertension: a single‐centre experience from South India

Keepanasseril

Pillai

Yavanasuriya

et al. 2019

BJOG

View full text Add to dashboard Cite

show abstract

“…For ES patients, a multidisciplinary approach is imperative and surgery should preferably be performed only at centers with expertise in the management of such patients, or in case of emergent or urgent situations, caregivers should seek consultation with expert centers throughout care. Pregnancy is still associated with a significant risk of both maternal and fetal mortality even though recent reports show better outcome than previously described as specialized care during pregnancy and delivery is now available [30,31]. However, given the severity and the high rate of complications associated with pregnancy, most PAH-CHD patients should still be advised against pregnancy.…”

Section: General Managementmentioning

confidence: 99%

The Changing Landscape of Pulmonary Arterial Hypertension in the Adult with Congenital Heart Disease

Dissel

Mulder

Bouma

2017

JCM

View full text Add to dashboard Cite

Pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is a common type of pulmonary arterial hypertension (PAH) and a frequent complication of congenital heart disease (CHD). PAH-CHD represents a heterogeneous patient population and it is important to distinguish between the underlying cardiac defects considering the prognostic and therapeutic implications. Improved interventional techniques have enabled repair or palliation of most cardiac defects, though a substantial number of patients remain at high risk for PAH after closure. Traditionally, the treatment and management of PAH-CHD patients has been limited to palliative and supportive care, and based on expert opinion rather than clinical trials. Recently, however, the availability of advanced PAH-specific treatment has opened up a new field for the clinical management of this condition. Nevertheless, there is limited evidence on the optimal therapeutic approach for PAH-CHD. Herein, we discuss the current and novel therapeutic options for PAH-CHD as well as highlight several challenges in the clinical management at present.

show abstract

“…Those who carried out the pregnancy and survived had preterm deliveries in half of the cases. These patients also required prolonged hospitalization before and after delivery, with some of them requiring cardiorespiratory mechanical support [166][167][168][169].…”

Section: Pregnancy and Pahmentioning

confidence: 99%

Idiopathic Pulmonary Arterial Hypertension in Children: A Review

Valencia

Krishnan

2017

Pulm Ther

View full text Add to dashboard Cite

Pediatric pulmonary hypertension (PH) is a heterogeneous disorder that leads to significant morbidity and mortality if left untreated. The Nice WHO classification from 2013 classifies PH into five groups: broadly, Group I pulmonary arterial hypertension (PAH), which includes idiopathic PAH, PAH associated with congenital heart disease and others; Group II comprises post-capillary PH (left heart disease), Group III comprises lung disease, Group IV thromboembolic disease and Group V miscellaneous causes of PH. The majority of pediatric PH comprise either Group I or Group III PH, but often children manifest features of several groups and are treated with targeted therapy. PAH in children requires a multifaceted approach. The pathogenesis is complex and it involves pulmonary vasoconstriction, endothelial dysfunction, inflammation and cell proliferation. Large multicenter and international registries have been formed with the aim of furthering understanding of this disease and developing appropriate therapeutic guidelines for managing pediatric PH. In this review, we describe the epidemiology, pathophysiology, clinical presentation, diagnosis and management of pediatric pulmonary hypertension.

show abstract

Pulmonary hypertension and pregnancy outcomes: data from the Registry Of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology

Cited by 198 publications

References 21 publications

Outcome of pregnancies in women with pulmonary hypertension: a single‐centre experience from South India

Outcome of pregnancies in women with pulmonary hypertension: a single‐centre experience from South India

The Changing Landscape of Pulmonary Arterial Hypertension in the Adult with Congenital Heart Disease

Idiopathic Pulmonary Arterial Hypertension in Children: A Review

Contact Info

Product

Resources

About