Outcome of pregnancies in pregnant women with pulmonary hypertension: a
single-center experience from East China
Abstract
In this study, we aim to find out maternal and fetal outcomes in women
with PH resulting from different causes and try to determine the risk
factors related to adverse maternal and fetal outcomes. We extracted the
data from the records: the demographic information, onset, course,
clinical and echocardiographic details, maternal and fetal
complications, management as well as obstetric data, which included
complications, infant of low-birth weight. We compared the outcome based
on the cause of disease and pulmonary hypertension pressure levels. 603
women were included in the final analysis, who were mainly had pulmonary
hypertension secondary to congenital heart disease (66.0%) and 46 of
whom had Eisenmenger syndrome (7.6%). The mortality was 3.0%, 56% of
which was caused by Eisenmenger syndrome. The abortion rate was 8.3%
and 32% of live newborns were born before term. Heart failure
complicated 17.1% and fetal growth restriction 3.5% of pregnancies.
Advanced medication was administered in an increasing number of
patients. Morbidity was significantly increased in women with pulmonary
hypertension associated with a pulmonary hypertension pressure ≥80 mmHg.
The mortality rate was lower than previously reported. Nevertheless, in
Eisenmenger syndrome, PH secondary to connective tissue disease and
idiopathic PH, the maternal mortality is still very high. In addition to
the use of PAH-targeted drugs, we believe that standardized maternal
management strategies can also help reduce mortality, including
screening for heart disease and effective transport of critically ill
patients. The maternal and infant outcome is related to etiology and the
severity of PASP.