Pulmonary hypertension in pregnancy: experience from 45 cases at a tertiary care center. (3rd May 2022)

• Record Type: Journal Article
• Authors: Ekici, Huseyin; Imamoglu, Metehan; Okmen, Firat; Ogultarhan, Rabia; Yeniel, Ahmet Ozgur
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 35:Number 9(2022)
• Page Start: 1769
• Page End: 1774
• Publication Date: 2022-05-03
• Subjects: Pulmonary hypertension -- pregnancy -- mortality -- preterm delivery -- WHO classification; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2020.1770216
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: Pulmonary hypertension (PH) is a rare maternal cardiac disorder associated with high maternal and fetal mortality. The objective of our study was to evaluate the maternal and fetal outcomes in pregnant women with PH in a single health center. Study design: 45 pregnant patients with PH, who had undergone antenatal follow-up and delivery at the department of gynecology and obstetrics at a referral center were retrospectively investigated. Maternal and perinatal outcomes were evaluated and descriptive statistics were reported. Results: According to the WHO classification; 35 patients (78%) were in Group 1; 9 patients (20%) in Group 2 and one patient (2%) were in Group 3. Thirty-three of the cases (73%) had mild, 8 (18%) moderate and 4 (9%) severe PH. The mean delivery week was 35.5. Twenty-four of the cases (56%) delivered before the 37th week and the remaining 19 cases (44%) in the 37th week or later. Rate of cesarean section delivery was 88%. Only one case of maternal death was reported, who was initially diagnosed with PAH during pregnancy. This patient had severe PH and was in Group 1 according to the WHO classification. Conclusion: While the mortality rates related to PH were reported to be between 30% and 56% several decades ago, recent studies have reported the mortality rates between 5% and 25%. It is believed that the decline in the maternal mortality depended on the developments in the treatment alternatives and multidisciplinary management. However, PH is still a serious condition which requires a multidisciplinary approach and a well-planned obstetric management.