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Published on: January 16, 2013
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Pregnancy and pulmonary hypertension
Petronella G Pieper1, Heleen Lameijer2, Elke S Hoendermis2
1Department of Cardiology, University Medical Centre Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Summary
Pregnancy with pulmonary hypertension poses risks, but targeted treatments have significantly reduced maternal mortality. Early intervention and planned delivery improve outcomes, though pregnancy remains contraindicated.
Area of Science:
- Cardiology
- Obstetrics
- Pulmonology
Background:
- Pulmonary hypertension during pregnancy presents significant maternal mortality and morbidity risks.
- Previous reviews highlighted high mortality rates, necessitating updated assessments.
Purpose of the Study:
- To systematically review the literature on targeted treatments for pulmonary arterial hypertension in pregnancy.
- To assess trends in maternal mortality and identify factors influencing outcomes.
Main Methods:
- Systematic literature review of studies on pulmonary arterial hypertension treatments during pregnancy.
- Analysis of mortality data from previous reviews (1998, 2009) and current literature.
Main Results:
- Maternal mortality has decreased significantly since 1998 (16% vs. 38%) and non-significantly since 2009 (16% vs. 25%).
- Timely treatment, early planned delivery, and potentially milder disease may contribute to better outcomes.
- No definitive proof of decreased mortality in women with mild pulmonary hypertension or favorable functional class.
Conclusions:
- Despite improved outcomes with targeted treatments, pregnancy is contraindicated in women with pulmonary hypertension.
- Consideration of termination is advised if pregnancy occurs.
- Management requires a multidisciplinary team in a specialist center for optimal care.
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