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Chapter 33 - Pulmonary Hypertension in Pregnancy

from Section 6 - Cardiopulmonary Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Marwa Salman ,
Amira El-Messidi  and
Anita Banerjee
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 28-year-old primigravida at 27 weeks’ gestation is referred by her primary care provider to your tertiary center’s high-risk obstetrics unit with a four-week history of worsening exertional dyspnea, marked fatigue with limited daily activities, and a recent syncopal episode, witnessed by her husband. She describes palpitations immediately prior to this brief event. She is asymptomatic at rest and has not experienced chest pain. Her medical history appears non-contributory, and although she practices healthy social habits, she has long-standing exercise intolerance in the non pregnant state with breathlessness after running a few meters.

Keywords

Pulmonary hypertension, etiologyGenetic counselling, heritable pulmonary arterial hypertensionWorld Health Organization (WHO) risk classificationInvestigationsDiagnostic evaluationTreatmentMaternal morbidity, mortalityPathophysiology, pregnancyMaternal-fetal outcomesAntenatal, intrapartum, postpartum managementVaginal deliveryElective Cesarean deliveryContraceptionBreastfeeding
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 433 - 443
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

American College of Obstetricians and Gynecologists’ Presidential Task Force on Pregnancy and Heart Disease and Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 212: Pregnancy and heart disease. Obstet Gynecol. 2019;133(5):e320–e356.CrossRefGoogle Scholar
Anjum, H, Surani, S. Pulmonary hypertension in pregnancy: a review. Medicina (Kaunas). 2021;57(3):259.CrossRefGoogle ScholarPubMed
Aryal, SR, Moussa, H, Sinkey, R, et al. Management of reproductive health in patients with pulmonary hypertension. Am J Obstet Gynecol MFM. 2020;2(2):100087.CrossRefGoogle ScholarPubMed
Ballard, W 3rd, Dixon, B, McEvoy, CA, et al. Pulmonary arterial hypertension in pregnancy. Cardiol Clin. 2021;39(1):109–118.CrossRefGoogle ScholarPubMed
Galiè, N, Humbert, M, Vachiery, JL, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Rev Esp Cardiol (Engl Ed). 2016;69(2):177.CrossRefGoogle ScholarPubMed
Kiely, DG, Condliffe, R, Wilson, VJ, et al. Pregnancy and pulmonary hypertension: a practical approach to management. Obstet Med. 2013;6(4):144–154.CrossRefGoogle ScholarPubMed
Low, TT, Guron, N, Ducas, R, et al. Pulmonary arterial hypertension in pregnancy-a systematic review of outcomes in the modern era. Pulm Circ. 2021;11(2):20458940211013671.CrossRefGoogle ScholarPubMed
Martin, SR, Edwards, A. Pulmonary hypertension and pregnancy. Obstet Gynecol. 2019;134(5):974–987. [Correction in Obstet Gynecol. 2020 Apr;135(4):978]CrossRefGoogle ScholarPubMed
Običan, SG, Cleary, KL. Pulmonary arterial hypertension in pregnancy. Semin Perinatol. 2014;38(5):289–294.CrossRefGoogle ScholarPubMed
Regitz-Zagrosek, V, Roos-Hesselink, JW, Bauersachs, J, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39(34):3165–3241.CrossRefGoogle ScholarPubMed

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