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Maternal and Fetal Outcomes in Pregnant Women with Pulmonary Arterial Hypertension: A Single-Center Experience and Review of Current Literature

BACKGROUND: Although pregnancy in women with pulmonary arterial hypertension has been considered a high-risk condition, current data regarding pregnancy with pulmonary arterial hypertension are scarce. In this study, we aimed to evaluate our single-center data on maternal and fetal outcomes in pregn...

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Autores principales: Ceren Tokgöz, Hacer, Yaşar Akbal, Özgür, Karagöz, Ali, Kültürsay, Barkın, Tanyeri, Seda, Keskin, Berhan, Hakgör, Aykun, Külahçıoğlu, Şeyhmus, Bayram, Zübeyde, Çağan Efe, Süleyman, Doğan, Cem, Halil Tanboğa, İbrahim, Özdemir, Nihal, Kaymaz, Cihangir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Turkish Society of Cardiology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9797754/
https://www.ncbi.nlm.nih.gov/pubmed/35983602
http://dx.doi.org/10.5152/AnatolJCardiol.2022.1762
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author Ceren Tokgöz, Hacer
Yaşar Akbal, Özgür
Karagöz, Ali
Kültürsay, Barkın
Tanyeri, Seda
Keskin, Berhan
Hakgör, Aykun
Külahçıoğlu, Şeyhmus
Bayram, Zübeyde
Çağan Efe, Süleyman
Doğan, Cem
Halil Tanboğa, İbrahim
Özdemir, Nihal
Kaymaz, Cihangir
author_facet Ceren Tokgöz, Hacer
Yaşar Akbal, Özgür
Karagöz, Ali
Kültürsay, Barkın
Tanyeri, Seda
Keskin, Berhan
Hakgör, Aykun
Külahçıoğlu, Şeyhmus
Bayram, Zübeyde
Çağan Efe, Süleyman
Doğan, Cem
Halil Tanboğa, İbrahim
Özdemir, Nihal
Kaymaz, Cihangir
author_sort Ceren Tokgöz, Hacer
collection PubMed
description BACKGROUND: Although pregnancy in women with pulmonary arterial hypertension has been considered a high-risk condition, current data regarding pregnancy with pulmonary arterial hypertension are scarce. In this study, we aimed to evaluate our single-center data on maternal and fetal outcomes in pregnant women with PAH and review currently available risk-based management strategies. METHODS: Our single-center study group comprised 35 women who became pregnant after the diagnosis of pulmonary arterial hypertension or in whom pulmonary arterial hypertension was diagnosed within early post-partum period . Clinical, laboratory, echocardiographic, and hemodynamic characteristics of pregnant and non-pregnant productive women with pulmonary arterial hypertension were compared, and similar comparison was also repeated for survivors and non-survivors in pregnant patient group. RESULTS: Pregnancy was noted in 15% of the 228 females with pulmonary arterial hypertension who were of hormonally productive ages, generally well-tolerated until delivery. Elective abortion and pre-term delivery were documented in 1 (2.8%) and 12 (35.3%) pregnant women, respectively. Switching to sildenafil was the standard medication during pregnancy. Cesarian section was the preferred method of delivery in all pregnant women with pulmonary arterial hypertension and was performed without any complication. Clinic deteoriation within the first week of delivery was observed in 5 (41.6%) patients. Maternal mortality was noted in 13 (37.1%) patients and was documented to cumulate within the first month of delivery. However, any sign predicting post-partum clinical deterioration was not found. No fetal mortality was observed. CONCLUSION: Despite the development of advanced therapies, pregnancy in pulmonary arterial hypertension still carries a high mortality risk and requires multi-disciplinary expert center care with more proactive management strategies.
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spelling pubmed-97977542023-01-04 Maternal and Fetal Outcomes in Pregnant Women with Pulmonary Arterial Hypertension: A Single-Center Experience and Review of Current Literature Ceren Tokgöz, Hacer Yaşar Akbal, Özgür Karagöz, Ali Kültürsay, Barkın Tanyeri, Seda Keskin, Berhan Hakgör, Aykun Külahçıoğlu, Şeyhmus Bayram, Zübeyde Çağan Efe, Süleyman Doğan, Cem Halil Tanboğa, İbrahim Özdemir, Nihal Kaymaz, Cihangir Anatol J Cardiol Original Investigation BACKGROUND: Although pregnancy in women with pulmonary arterial hypertension has been considered a high-risk condition, current data regarding pregnancy with pulmonary arterial hypertension are scarce. In this study, we aimed to evaluate our single-center data on maternal and fetal outcomes in pregnant women with PAH and review currently available risk-based management strategies. METHODS: Our single-center study group comprised 35 women who became pregnant after the diagnosis of pulmonary arterial hypertension or in whom pulmonary arterial hypertension was diagnosed within early post-partum period . Clinical, laboratory, echocardiographic, and hemodynamic characteristics of pregnant and non-pregnant productive women with pulmonary arterial hypertension were compared, and similar comparison was also repeated for survivors and non-survivors in pregnant patient group. RESULTS: Pregnancy was noted in 15% of the 228 females with pulmonary arterial hypertension who were of hormonally productive ages, generally well-tolerated until delivery. Elective abortion and pre-term delivery were documented in 1 (2.8%) and 12 (35.3%) pregnant women, respectively. Switching to sildenafil was the standard medication during pregnancy. Cesarian section was the preferred method of delivery in all pregnant women with pulmonary arterial hypertension and was performed without any complication. Clinic deteoriation within the first week of delivery was observed in 5 (41.6%) patients. Maternal mortality was noted in 13 (37.1%) patients and was documented to cumulate within the first month of delivery. However, any sign predicting post-partum clinical deterioration was not found. No fetal mortality was observed. CONCLUSION: Despite the development of advanced therapies, pregnancy in pulmonary arterial hypertension still carries a high mortality risk and requires multi-disciplinary expert center care with more proactive management strategies. Turkish Society of Cardiology 2022-12-01 /pmc/articles/PMC9797754/ /pubmed/35983602 http://dx.doi.org/10.5152/AnatolJCardiol.2022.1762 Text en 2022 authors https://creativecommons.org/licenses/by-nc/4.0/ Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Original Investigation
Ceren Tokgöz, Hacer
Yaşar Akbal, Özgür
Karagöz, Ali
Kültürsay, Barkın
Tanyeri, Seda
Keskin, Berhan
Hakgör, Aykun
Külahçıoğlu, Şeyhmus
Bayram, Zübeyde
Çağan Efe, Süleyman
Doğan, Cem
Halil Tanboğa, İbrahim
Özdemir, Nihal
Kaymaz, Cihangir
Maternal and Fetal Outcomes in Pregnant Women with Pulmonary Arterial Hypertension: A Single-Center Experience and Review of Current Literature
title Maternal and Fetal Outcomes in Pregnant Women with Pulmonary Arterial Hypertension: A Single-Center Experience and Review of Current Literature
title_full Maternal and Fetal Outcomes in Pregnant Women with Pulmonary Arterial Hypertension: A Single-Center Experience and Review of Current Literature
title_fullStr Maternal and Fetal Outcomes in Pregnant Women with Pulmonary Arterial Hypertension: A Single-Center Experience and Review of Current Literature
title_full_unstemmed Maternal and Fetal Outcomes in Pregnant Women with Pulmonary Arterial Hypertension: A Single-Center Experience and Review of Current Literature
title_short Maternal and Fetal Outcomes in Pregnant Women with Pulmonary Arterial Hypertension: A Single-Center Experience and Review of Current Literature
title_sort maternal and fetal outcomes in pregnant women with pulmonary arterial hypertension: a single-center experience and review of current literature
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9797754/
https://www.ncbi.nlm.nih.gov/pubmed/35983602
http://dx.doi.org/10.5152/AnatolJCardiol.2022.1762
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