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Pulmonary Hypertension in Pregnancy
Debasree Banerjee1,2, Corey E Ventetuolo1,2,3
1Division of Pulmonary, Critical Care, and Sleep, Rhode Island Hospital, Providence, Rhode Island.
Pregnancy poses significant risks for women with pulmonary arterial hypertension (PAH) due to severe cardiopulmonary changes. Current recommendations still advise against pregnancy in PAH patients because of poor maternal and fetal outcomes.
Area of Science:
- Cardiology
- Pulmonology
- Reproductive Medicine
Background:
- Pulmonary arterial hypertension (PAH) is a severe vasculopathy leading to right heart failure and reduced life expectancy.
- Young women are disproportionately affected by PAH.
- Pregnancy in women with PAH carries high risks for both mother and fetus.
Purpose of the Study:
- To review the physiological and hormonal adaptations during pregnancy in relation to pulmonary vascular disease and right heart function.
- To discuss current consensus recommendations for managing pregnancy in women with PAH.
- To outline management strategies for pregnant women with PAH.
Main Methods:
- Literature review of physiological and hormonal changes during pregnancy.
- Analysis of current consensus guidelines and recommendations.
- Synthesis of management approaches for pregnancy in PAH.
Main Results:
- Physiological and hormonal changes in pregnancy can be poorly tolerated in women with PAH.
- Despite new therapies, pregnancy is still associated with poor outcomes.
- Management requires careful consideration of maternal and fetal risks.
Conclusions:
- Pregnancy in women with PAH remains high-risk, necessitating careful management.
- Understanding hormonal and physiological changes is crucial for patient care.
- Pregnancy avoidance or termination is often recommended due to poor outcomes.
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