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Pregnancy and pulmonary hypertension
C Randall Lane1, Terence K Trow2
1Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, 333 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA.
Clinics in Chest Medicine
|February 1, 2011
Summary
Pregnancy significantly increases risks for individuals with pulmonary hypertension (PH), often leading to right ventricular failure and high mortality rates (25-30%). Affected patients should avoid pregnancy due to these severe risks.
Area of Science:
- Cardiology
- Maternal-Fetal Medicine
- Pulmonary Medicine
Background:
- Pulmonary hypertension (PH) poses a severe risk during pregnancy.
- Physiologic changes in pregnancy can exacerbate right ventricular strain.
- High mortality rates (25-30%) underscore the danger of PH in pregnancy.
Purpose of the Study:
- To review the physiological challenges of pregnancy in patients with PH.
- To discuss diagnostic difficulties, particularly with transthoracic echocardiography.
- To examine historical mortality data and management strategies for pregnant patients with PH.
Main Methods:
- Review of physiological adaptations during pregnancy.
- Analysis of diagnostic limitations of echocardiography in pregnant PH patients.
- Examination of historical mortality statistics and case reports.
- Literature review on management of PH in pregnant individuals.
Main Results:
- Pregnancy-induced physiological stress significantly strains the right ventricle in PH patients.
- Transthoracic echocardiography may have limitations in diagnosing PH during pregnancy.
- Historical data indicates a high mortality rate (25-30%) for pregnant individuals with PH.
Conclusions:
- Pregnancy is contraindicated for patients with pulmonary hypertension due to high mortality risks.
- Careful consideration of diagnostic tools and management is crucial for the few who continue pregnancy.
- Further research is needed on managing PH during pregnancy, though avoidance is recommended.
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