Pulmonary vascular disease and pregnancy: current controversies, management strategies, and perspectives

Weiss, Branko M.; Hess, O. M.

doi:10.1053/euhj.1999.1701

Cited by 172 publications

(118 citation statements)

References 141 publications

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“…These differences were attributable to additional adverse factors such as hepatitis, systemic connective tissue, or vascular inflammatory disease. In spite of strict current management protocol, pulmonary vascular disease is associated with an ominous maternal prognosis, independent of the underlying cause, 34 and pregnancy is absolutely contraindicated in women with pulmonary vascular disease.…”

Section: Miscellaneousmentioning

confidence: 99%

Pregnancy in patients with heart disease: Experience with 1,000 cases

Ávila

Rossi

Ramires

et al. 2003

Clinical Cardiology

233

110

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SummaryBackground: Previously, the high maternal mortality in cardiac patients who became pregnant prompted the assertion: Women with an abnormal heart should not become pregnant. This long-standing notion needs to be revised today.Hypothesis: The study was undertaken to ascertain the experience with a large series of pregnant women with cardiac disease cared for in the same referral center.Methods: From 1989 to 1999, 1,000 pregnant women with heart disease were followed by the same clinical and obstetric team. The cardiac diseases included rheumatic heart disease (55.7%), congenital heart disease (19.1%), Chagas' disease (8.5%), cardiac arrhythmias (5.1%), cardiomyopathies (4.3%), and others (7.3%).Results: Of the pregnant women studied, 765 (76.5%) experienced no cardiovascular events during the study; 235 (23.5%) patients had the following cardiovascular complications: congestive heart failure (12.3%), cardiac arrhythmias (6%), thromboembolism (1.9%), angina (1.4%), hypoxemia (0.7%), infective endocarditis (0.5%), and other complications (0.7%). Clinical treatment allowed adequate management in 161 (68.8%) patients; however, 46 (19.6%) patients underwent interventional procedures because of refractory complications. The general maternal mortality rate was 2.7%. Of the 915 (91.5%) infants who were discharged, 119 (13%) were premature.

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Section: Miscellaneousmentioning

confidence: 99%

Pregnancy in patients with heart disease: Experience with 1,000 cases

Ávila

Rossi

Ramires

et al. 2003

Clinical Cardiology

233

110

View full text Add to dashboard Cite

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“…The haemodynamic stress of labour causes hypercarbia and acidosis which leads to acute rise in pulmonary pressures leading to right heart failure. [16][17][18][19] Due to the uterine contractions and loss of blood during delivery, there is huge shift in blood volume. Also, vasovagal reaction to pain, acidosis and hypercarbia associated with vaginal delivery further aggravate the pulmonary artery hypertension.…”

Section: Discussionmentioning

confidence: 99%

Successful maternal outcome after vaginal delivery in a patient with Eisenmenger Syndrome

Chauhan

Agarwal

Gupta

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Patients with Eisenmenger syndrome are advised against pregnancy. Sometimes patients are diagnosed with Eisenmenger syndrome for the first time during pregnancy. This is what has happened in our case. A primigravida was diagnosed with ventricular septal defect with severe pulmonary artery hypertension for the first time during pregnancy at 34 weeks period of gestation. Management of such patients is challenging with different studies showing variable results. Here we describe such a case which was managed conservatively and was allowed to go into labour spontaneously with vacuum extraction during second stage which subsequently led to a favourable maternal outcome.

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“…Inhaled nitric oxide use is not without side effects. 16 Pulmonary vasodilators including prostaglandins are not recommended during pregnancy because of possible teratogenicity and adverse effects on uterine circulation. 6 The cost and availability of recommended selective pulmonary vasodilators (IV epoprostenol, IV/inhaled iloprost, IV/SC treprostinil, inhaled nitric oxide) 12 is a serious concern in our country.…”

Section: Discussionmentioning

confidence: 99%