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Primary pulmonary hypertension during pregnancy: A case report
Hanan B Albackr1, Lateefa O Aldakhil, Alshaer Ahamd
1King Fahad Cardiac Center, King Khalid University Hospital College of Medicine, King Saud University, Saudi Arabia.
Journal of the Saudi Heart Association
|November 1, 2013
Summary
This case study details managing severe primary pulmonary hypertension in a pregnant woman. Effective treatment involved a multidisciplinary approach, including nitric oxide, nebulized iloprost, and sildenafil, ensuring a healthy infant delivery.
Area of Science:
- Cardiology
- Pulmonology
- Obstetrics
Background:
- Severe primary pulmonary hypertension (PPH) poses significant risks during pregnancy.
- Management requires careful consideration of maternal and fetal well-being.
Purpose of the Study:
- To describe the successful management of a pregnant patient with severe PPH.
- To highlight therapeutic strategies for PPH during pregnancy and delivery.
Main Methods:
- Case report of a 25-year-old pregnant woman with severe PPH.
- Echocardiography revealed significant right ventricular hypertrophy and dysfunction (RVSP 125 mmHg).
- Management included elective cesarean section, intraoperative nitric oxide, and postoperative nebulized iloprost and sildenafil.
Main Results:
- Successful delivery of a healthy infant at 32 weeks gestation.
- Pulmonary artery pressures (102 mmHg) and resistance (429) were high pre-anesthesia.
- Postoperative PASP was controlled with nebulized iloprost and sildenafil, with continued sildenafil and warfarin therapy.
Conclusions:
- Multimodal therapy can effectively manage severe PPH in pregnancy.
- Cesarean delivery under general anesthesia was feasible with intraoperative support.
- Pharmacological management with iloprost and sildenafil, alongside anticoagulation, stabilized the patient post-delivery.
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