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Review Article
- Pulmonary
- Critical care management of pulmonary arterial hypertension in pregnancy: the pre-, peri- and post-partum stages
- Vorakamol Phoophiboon, Monvasi Pachinburavan, Nicha Ruamsap, Natthawan Sanguanwong, Nattapong Jaimchariyatam
- Acute Crit Care. 2021;36(4):286-293. Published online November 26, 2021
- DOI: https://doi.org/10.4266/acc.2021.00458
- 6,496 View
- 431 Download
- 3 Web of Science
- 5 Crossref
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Abstract
PDF - The mortality rate of pulmonary hypertension in pregnancy is 25%–56%. Pulmonary arterial hypertension is the highest incidence among this group, especially in young women. Despite clear recommendation of pregnancy avoidance, certain groups of patients are initially diagnosed during the gestational age step into the third trimester. While the presence of right ventricular failure in early gestation is usually trivial, it can be more severe in the late trimester. Current evidence shows no consensus in the management and serious precautions for each stage of the pre-, peri- and post-partum periods of this specific group. Pulmonary hypertension-targeted drugs, mode of delivery, type of anesthesia, and some avoidances should be planned among a multidisciplinary team to enhance maternal and fetal survival opportunities. Sudden circulatory collapse from cardiac decompensation during the peri- and post-partum phases is detrimental, and mechanical support such as extracorporeal membrane oxygenation should be considered for mitigating hemodynamics and extending cardiac recovery time. Our review aims to explain the pathophysiology of pulmonary arterial hypertension and summarize the current evidence for critical management and precautions in each stage of pregnancy.
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Citations
Citations to this article as recorded by
- Maternal Outcomes Among Pregnant Women With Congenital Heart Disease–Associated Pulmonary Hypertension
Qian Zhang, Fang Zhu, Guocheng Shi, Chen Hu, Weituo Zhang, Puzhen Huang, Chunfeng Zhu, Hong Gu, Dong Yang, Qiangqiang Li, Yonghua Niu, Hao Chen, Ruixiang Ma, Ziyi Pan, Huixian Miao, Xin Zhang, Genxia Li, Yabing Tang, Guyuan Qiao, Yichen Yan, Zhongqun Zhu,
Circulation.2023; 147(7): 549. CrossRef - Pregnancy in Patients with Pulmonary Arterial Hypertension in Light of New ESC Guidelines on Pulmonary Hypertension
Karolina Barańska-Pawełczak, Celina Wojciechowska, Wojciech Jacheć
International Journal of Environmental Research and Public Health.2023; 20(5): 4625. CrossRef - Pregnancy in Severe Pulmonary Hypertension: A Case Report and Literature Analysis
一人 王
Advances in Clinical Medicine.2023; 13(10): 16433. CrossRef - Effects of maternal pulmonary arterial hypertension on fetal hemodynamics and maternal‐fetal outcome in late pregnancy
Yuan Yuan Xing, Yanping Ruan, Huai Qin, Lei Zhao, Qing Zhao, Yun Wei, Jie Chen, Xiaohai Ma
Echocardiography.2023; 40(12): 1339. CrossRef - Clinical Analysis in 82 Pregnant Women with the Severity of Pulmonary Hypertension
安芬 李
Advances in Clinical Medicine.2023; 13(11): 18492. CrossRef
- Maternal Outcomes Among Pregnant Women With Congenital Heart Disease–Associated Pulmonary Hypertension
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