Pulmonary arterial hypertension in pregnant women

Author:

Safdar Zeenat1

Affiliation:

1. Assistant Professor of Medicine, Associate Director, Baylor Pulmonary Hypertension Center, Pulmonary-Critical Care Medicine, Baylor College of Medicine, Houston, TX 77030, USA

Abstract

Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling that limits the ability of the pulmonary vascular bed to withstand the physiological changes of pregnancy. Historically, pregnancy in PAH carries a high risk to the parturient. Normal pulmonary vasculature can withstand the hemodynamic and physiological changes associated with pregnancy without the development of respiratory symptomatology. However, in the presence of pulmonary vascular remodeling the capacity to handle these changes is compromised. During pregnancy, increase in cardiac output from the increased intravascular volume can lead to right heart failure. Therefore, all patients with PAH of childbearing potential should receive preconception counseling and be advised to use two methods of contraception. Patients with PAH should be advised against continuing pregnancy if they do become pregnant. According to the literature, deterioration in pregnancy mainly occurs in the second trimester and early in the third trimester; immediately postpartum is the most critical time for patients with PAH. In this review, we will discuss the recent advances in the management of parturient patients with PAH.

Publisher

SAGE Publications

Subject

Pharmacology (medical),Pulmonary and Respiratory Medicine

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1. Postpartum diagnosis and management of pulmonary arterial hypertension;Obstetric Medicine;2023-10-30

2. Reproductive Care in Pulmonary Arterial Hypertension;Journal of Cardiac Failure;2023-09

3. Management of pulmonary arterial hypertension during pregnancy;Expert Review of Respiratory Medicine;2023-05-04

4. Pregnancy in Patients with Pulmonary Arterial Hypertension in Light of New ESC Guidelines on Pulmonary Hypertension;International Journal of Environmental Research and Public Health;2023-03-06

5. Pulmonary arterial hypertension in pregnancy;Current Opinion in Cardiology;2023-03-01

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