Pregnancy in pulmonary arterial hypertension (RCD code: VII‑II‑1)
Journal Title: Journal of Rare Cardiovascular Diseases - Year 2016, Vol 2, Issue 7
Abstract
Pulmonary arterial hypertension (PAH) is a progressive disease leading to right ventricular failure and death, if not treated adequately. Pregnancy in women with PAH is associated with significantly high mortality, thus current guidelines strongly recommend, that pregnancy in PAH female patients should be avoided and in the case of pregnancy, termination at early stage is recommended. We present results of a study aimed at assesing maternal and newborn outcomes in gravidas with PAH. Five pregnant females with PAH in the mean age of 29.6 ±8.23 years were included in the study. In two patients idiopathic PAH (IPAH) and in three PAH due to congenital heart defects and Eisenmenger syndrome were diagnosed. Three patients received PAH-specific therapy (monotherapy) prior to pregnancy. During pregnancy two women received sildenafil, then treprostinil (one started in 33rd week of gestation, second few hours before labour). Two patients did not received PAH specific therapy due to non-availability in Poland at that time and one according to treatment denial. In one case spontaneous abortion at the 8th week of pregnancy occurred and one of the patients reported 4 previous miscarriages. Two patients are still alive, one is lost to follow-up and two of them died: one in the postpartum period and the second ca. 18 month after abortion. All newborns survived.Considering the high mortality rate among pregnant women with PAH, pregnancy is strongly contraindicated. If the patient decides to continue pregnancy she should be under medical care in a specialist centre with a multidisciplinary approach and PAH specific treatment should be administered.
Authors and Affiliations
Magdalena Kaźnica-Wiatr, Agata Leśniak-Sobelga, Grzegorz Kopeć, Piotr Błaszczak, Karolina Frynas, Maria Olszowska, Krzysztof Rytlewski, Jarosław Kasprzak
Keywords
Related Articles
- EP ID EP245347
- DOI 10.20418/jrcd.vol2no7.235
- Views 94
- Downloads 0
Highlights from the Polish Pulmonary Hypertension Patients and their Friends Meeting in Krakow
Annual Meeting of the Pulmonary Hypertension Patients and their Friends organized by Pulmonary Hypertension Association (PHA) of Poland was held on June 11, 2016 at the Department of Cardiac and Vascular Diseases of the...
Right atrial myxoma in a patient with Budd‐Chiari syndrome
Budd‐Chiari syndrome (BCS) is a rare clinical disorder which is caused by obstruction of the major hepatic veins or suprahepatic portion of the inferior vena cava. Either thrombosis or a mechanical venous obstruction may...
Clinical manifestations and treatment of Anderson-Fabry disease in a middle age man (RCD code: III-2B.2a)
Fabry disease is a genetic lysosomal storage disease (X-linked inheritance), also known as Anderson Fabry disease. It is a lifelong progressive disease, and it develops in patients with the lack of lysosomal enzyme alpha...
Spontaneous implantation of a left atrial myxoma into the left ventricle (RCD code: VI‑1A.1)
Myxomas are one of the most common cardiac tumors. In 70–80% of cases they are located in the left atrium, 10–20% in the right atrium and in less than 10% in ventricles. We report a case of a 60-year-old patient after my...
Spontaneous coronary artery dissection secondary to intimal fibromuscular dysplasia (RCD code: I‑1C.O)
Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory arterial disease of unknown etiology. Histologically, FMD is classified on the basis of arterial layer involved into intimal, medial and perimedial...