Pregnancy in pulmonary arterial hypertension: mid-term outcomes of mothers and offspring

Current pulmonary hypertension guidelines recommend that patients with pulmonary arterial hypertension (PAH) avoid pregnancy because of high mortality risk for patients and offspring. Still, some patients become pregnant. The experiences we made over the last 12 years encouraged for a retrospective view on pregnancy outcomes in our PAH patient base. We herein report the mid-term maternal and offspring outcomes of 25 consecutive pregnancies in 16 patients with PAH between 2007 and 2019. Five patients had a total of 8 abortions (5 spontaneous, 3 induced; one of these patients developed right ventricular failure and underwent urgent lung transplantation). Thirteen patients delivered a total of 18 healthy children. One of these patients developed right heart failure in the postpartum period, requiring urgent lung transplantation (both patients developing right heart failure were strongly advised against pregnancy). All other patients were alive after a follow-up period of 1-12 (median, 6) years, 6 patients showed worsening within 9-22 months after delivery but responded favorably to therapy escalation. Their infants were also doing well and had normal results on a standardized infant developmental questionnaire. Today, an individualized risk-based approach with shared decision making may be an appropriate approach to pregnancy in PAH.Reference:Kamp JC et al. Pregnancy in pulmonary arterial hypertension: Mid-term outcomes of mothers and offspring. J Heart Lung Transplant. 2020 Dec...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research