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Inhaled nitric oxide for primary pulmonary hypertension in pregnancy
G K Lam1, R E Stafford, J Thorp
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599, USA. garrett_lam@med.unc.edu
Background:
Primary pulmonary hypertension is a rare and dangerous entity in pregnancy. Previous studies have found a 35-50% maternal mortality rate in the peripartum period. To date, most reports have described treatment of these patients with diuretics, digoxin, and calcium-channel blockers.
Case:
We describe the successful treatment of a primigravida with severe primary pulmonary hypertension. We used elective intubation before labor, inhaled nitric oxide therapy, and assisted vaginal delivery with epidural anesthesia that resulted in a viable infant and survival of the mother.
Conclusion:
Nitric oxide can be used to successfully treat primary pulmonary hypertension in pregnancy.