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Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years
BACKGROUND: Pulmonary hypertension (PH) in pregnancy is associated with a high maternal mortality and morbidity and has been found to be as high as 30-56%. AIM: To review the management of such patients in a tertiary center over a 15 year period, as the current literature consists of a few case repo...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881648/ https://www.ncbi.nlm.nih.gov/pubmed/25849682 http://dx.doi.org/10.4103/0971-9784.154466 |
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author | Monagle, John Manikappa, Shashikanth Ingram, Brendan Malkoutzis, Vangy |
author_facet | Monagle, John Manikappa, Shashikanth Ingram, Brendan Malkoutzis, Vangy |
author_sort | Monagle, John |
collection | PubMed |
description | BACKGROUND: Pulmonary hypertension (PH) in pregnancy is associated with a high maternal mortality and morbidity and has been found to be as high as 30-56%. AIM: To review the management of such patients in a tertiary center over a 15 year period, as the current literature consists of a few case reports, a few small case series and 2 meta-analyses. MATERIALS AND METHODS: A review of all patients admitted to our institution for management of PH in pregnancy between 1994 and February 2009 was undertaken. Cases were identified from the high-risk pregnancy database within the department of anesthesia and from the hospital medical records. Severity of PH, type of PH, NYHA functional status at presentation and delivery, mode of delivery, peripartum monitoring and APGAR scores were noted. Patients were reviewed by a multidisciplinary team and management planned accordingly. RESULTS: 19 eligible patients were identified. Patients who were significantly sick due to their PH were aggressively managed during pregnancy. Overall there was an improvement in NYHA functional status at the time of delivery. Epidural analgesia and anesthesia for labor and operatively delivery seem to be the ideal choice. CONCLUSION: Multidisciplinary approach is a key to the successful management of these patients. Secondary PH results in higher morbidity and mortality, in particular, older the age higher the maternal morbidity and mortality. |
format | Online Article Text |
id | pubmed-4881648 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-48816482016-06-16 Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years Monagle, John Manikappa, Shashikanth Ingram, Brendan Malkoutzis, Vangy Ann Card Anaesth Original Article BACKGROUND: Pulmonary hypertension (PH) in pregnancy is associated with a high maternal mortality and morbidity and has been found to be as high as 30-56%. AIM: To review the management of such patients in a tertiary center over a 15 year period, as the current literature consists of a few case reports, a few small case series and 2 meta-analyses. MATERIALS AND METHODS: A review of all patients admitted to our institution for management of PH in pregnancy between 1994 and February 2009 was undertaken. Cases were identified from the high-risk pregnancy database within the department of anesthesia and from the hospital medical records. Severity of PH, type of PH, NYHA functional status at presentation and delivery, mode of delivery, peripartum monitoring and APGAR scores were noted. Patients were reviewed by a multidisciplinary team and management planned accordingly. RESULTS: 19 eligible patients were identified. Patients who were significantly sick due to their PH were aggressively managed during pregnancy. Overall there was an improvement in NYHA functional status at the time of delivery. Epidural analgesia and anesthesia for labor and operatively delivery seem to be the ideal choice. CONCLUSION: Multidisciplinary approach is a key to the successful management of these patients. Secondary PH results in higher morbidity and mortality, in particular, older the age higher the maternal morbidity and mortality. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4881648/ /pubmed/25849682 http://dx.doi.org/10.4103/0971-9784.154466 Text en Copyright: © 2015 Annals of Cardiac Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Monagle, John Manikappa, Shashikanth Ingram, Brendan Malkoutzis, Vangy Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years |
title | Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years |
title_full | Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years |
title_fullStr | Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years |
title_full_unstemmed | Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years |
title_short | Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years |
title_sort | pulmonary hypertension and pregnancy: the experience of a tertiary institution over 15 years |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881648/ https://www.ncbi.nlm.nih.gov/pubmed/25849682 http://dx.doi.org/10.4103/0971-9784.154466 |
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