Management of pulmonary arterial hypertension during pregnancy

References

• Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG). Eur Heart J. 2022;43(38):3618–3731. DOI:10.1093/eurheartj/ehac237
   PubMed Web of Science ®Google Scholar
• Bédard E, Dimopoulos K, Gatzoulis MA. Has there been any progress made on pregnancy outcomes among women with pulmonary arterial hypertension? Eur Heart J. 2009;30(3):256–265.
   PubMed Web of Science ®Google Scholar
• Cheron C, McBride SA, Antigny F, et al. Sex and gender in pulmonary arterial hypertension. Eur Respir Rev. 2021;30162. :200330. [cited 2023 Feb 6]. doi: 10.1183/16000617.0330-2020
   PubMed Web of Science ®Google Scholar
• Weiss BM, Zemp L, Seifert B, et al. Outcome of pulmonary vascular disease in pregnancy: a systematic overview from 1978 through 1996. J Am Coll Cardiol. 1998;31(7):1650–1657. DOI:10.1016/S0735-1097(98)00162-4
   PubMed Web of Science ®Google Scholar
• Low T-T, 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):20458940211013670. DOI:10.1177/20458940211013671
   Google Scholar
• Luo J, Shi H, Xu L, et al. Pregnancy outcomes in patients with pulmonary arterial hypertension: a retrospective study. Medicine (Baltimore). 2020;99(23):e20285. DOI:10.1097/MD.0000000000020285
   PubMed Web of Science ®Google Scholar
• Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. ESC Guidelines for the management of cardiovascular diseases during pregnancy: the task force for the management of cardiovascular diseases during pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(34):3165–3241. DOI:10.1093/eurheartj/ehy340
   PubMed Web of Science ®Google Scholar
• Thomas E, Yang J, Xu J, et al. Pulmonary hypertension and pregnancy outcomes: insights from the national inpatient sample. J Am Heart Assoc. 2017;6(10):e006144. DOI:10.1161/JAHA.117.006144
   PubMed Web of Science ®Google Scholar
• Madden BP. Pulmonary hypertension and pregnancy. Int J Obstet Anesth. 2009;18(2):156–164.
   PubMed Web of Science ®Google Scholar
• Safdar Z. Pulmonary arterial hypertension in pregnant women. Ther Adv Respir Dis. 2013;7(1):51–63.
   PubMed Web of Science ®Google Scholar
• Clark SL, Cotton DB, Lee W, et al. Central hemodynamic assessment of normal term pregnancy. Am J Clin Exp Obstet Gynecol. 1989;161(6):1439–1442. DOI:10.1016/0002-9378(89)90900-9
   Google Scholar
• Gandhi MH, Gupta V. Physiology, maternal blood. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Dec 19]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK557783/.
   Google Scholar
• Irani RA, Xia Y. The functional role of the renin–angiotensin system in pregnancy and preeclampsia. Placenta. 2008;29(9):763–771.
   PubMed Web of Science ®Google Scholar
• Sanghavi M, Rutherford JD. Cardiovascular physiology of pregnancy. Circulation. 2014;130(12):1003–1008.
   PubMed Web of Science ®Google Scholar
• James AH. Venous thromboembolism in pregnancy. Arteriosclerosis Thrombosis Vasc Biol. 2009;29(3):326–331.
   PubMed Web of Science ®Google Scholar
• Kiely DG, Condliffe R, Wilson VJ, et al. Pregnancy and pulmonary hypertension: a practical approach to management. Obstet Med. 2013;6(4):144–154. DOI:10.1177/1753495X13495193
   PubMedGoogle Scholar
• Naeije R, Manes A. The right ventricle in pulmonary arterial hypertension. Eur Respir Rev. 2014;23(134):476–487.
   PubMedGoogle Scholar
• Ladouceur M, Benoit L, Radojevic J, et al. Pregnancy outcomes in patients with pulmonary arterial hypertension associated with congenital heart disease. Heart. 2017;103(4):287–292. DOI:10.1136/heartjnl-2016-310003
   PubMed Web of Science ®Google Scholar
• Hsu C-H, Gomberg-Maitland M, Glassner C, et al. The management of pregnancy and pregnancy-related medical conditions in pulmonary arterial hypertension patients. Int J Clin Pract. 2011;65:6–14.
   PubMed Web of Science ®Google Scholar
• Sliwa K, van Hagen IM, Budts W, et al. Pulmonary hypertension and pregnancy outcomes: data from the Registry of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology. Eur J Heart Fail. 2016;18(9):1119–1128. DOI:10.1002/ejhf.594
   PubMed Web of Science ®Google Scholar
• Lim K, Chang S-A, Oh S, et al. Pulmonary arterial hypertension and pregnancy: single center experience in current era of targeted therapy. Korean Circ J. 2019;49(6):545. DOI:10.4070/kcj.2018.0350
   PubMed Web of Science ®Google Scholar
• Yang JZ, Fernandes TM, Kim NH, et al. Pregnancy and pulmonary arterial hypertension: a case series and literature review. Am J Obstet Gynecol MFM. 2021 [cited 19 Dec 2022];34. :100358. doi: 10.1016/j.ajogmf.2021.100358
   PubMed Web of Science ®Google Scholar
• Daraz Y, Murthy S, Wolfe D. Pregnancy in pulmonary arterial hypertension: a multidisciplinary approach. J Cardiovasc Dev Dis. 2022;9(6):196.
   PubMed Web of Science ®Google Scholar
• Pieper PG, Hoendermis ES. Pregnancy in women with pulmonary hypertension. Neth Heart J. 2011;19(12):504–508.
   PubMed Web of Science ®Google Scholar
• Martínez MV, Rutherford JD. Pulmonary hypertension in pregnancy. Cardiol Rev. 2013;21(4):167.
   PubMed Web of Science ®Google Scholar
• Thrombosis and embolism during pregnancy and the puerperium: acute management (Green-top Guideline No. 37b) [Internet]. RCOG. [cited 2023 Jan 17]. Ava: https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/thrombosis-and-embolism-during-pregnancy-and-the-puerperium-acute-management-green-top-guideline-no-37b/.
   Google Scholar
• Kaur K, Bhardwaj M, Kumar P, et al. Amniotic fluid embolism. J Anaesthesiol Clin Pharmacol. 2016;32(2):153–159. DOI:10.4103/0970-9185.173356
   PubMedGoogle Scholar
• Stafford IA, Moaddab A, Dildy GA, et al. Amniotic fluid embolism syndrome: analysis of the United States International Registry. Am J Obstet Gynecol MFM. 2020;2(2):100083. DOI:10.1016/j.ajogmf.2019.100083
   PubMed Web of Science ®Google Scholar
• Yuan S-M. Eisenmenger syndrome in pregnancy. Braz J Cardiovasc Surg. 2016;31:325.
   PubMed Web of Science ®Google Scholar
• Presbitero P, Somerville J, Stone S, et al. Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus. Circulation. 1994;89(6):2673–2676. DOI:10.1161/01.CIR.89.6.2673
   PubMed Web of Science ®Google Scholar
• Gleicher N, Midwall J, Hochberger D, et al. Eisenmengerʼs syndrome and pregnancy. Obstetrical & Gynecological Survey. 1979;34(10):721. DOI:10.1097/00006254-197910000-00001
   PubMedGoogle Scholar
• Pieper PG, Lameijer H, Hoendermis ES. Pregnancy and pulmonary hypertension. Baillieres Best Pract Res Clin Obstet Gynaecol. 2014;28(4):579–591.
   PubMed Web of Science ®Google Scholar
• Duarte AG, Thomas S, Safdar Z, et al. Management of pulmonary arterial hypertension during pregnancy: a retrospective, multicenter experience. Chest. 2013;143(5):1330–1336. DOI:10.1378/chest.12-0528
   PubMed Web of Science ®Google Scholar
• Jaïs X, Olsson KM, Barbera JA, et al. Pregnancy outcomes in pulmonary arterial hypertension in the modern management era. Eur Respir J. 2012;40(4):881–885. DOI:10.1183/09031936.00141211
   PubMed Web of Science ®Google Scholar
• Ma L, Liu W, Huang Y. Perioperative management for parturients with pulmonary hypertension: experience with 30 consecutive cases. Front Med. 2012;6(3):307–310.
   PubMedGoogle Scholar
• Corbach N, Berlier C, Lichtblau M, et al. Favorable pregnancy outcomes in women with well-controlled pulmonary arterial hypertension. Front Med. 2021;8:689764.
   Web of Science ®Google Scholar
• Katsuragi S, Yamanaka K, Neki R, et al. Maternal outcome in pregnancy complicated with pulmonary arterial hypertension. Circ J. 2012;76(9):2249–2254. DOI:10.1253/circj.CJ-12-0235
   PubMed Web of Science ®Google Scholar
• Subbaiah M, Kumar S, Roy KK, et al. Pregnancy outcome in women with pulmonary arterial hypertension: single-center experience from India. Arch Gynecol Obstet. 2013;288(2):305–309. DOI:10.1007/s00404-013-2761-8
   PubMed Web of Science ®Google Scholar
• Li Q, Dimopoulos K, Liu T, et al. Peripartum outcomes in a large population of women with pulmonary arterial hypertension associated with congenital heart disease. Eur J Prev Cardiol. 2019;26(10):1067–1076. DOI:10.1177/2047487318821246
   PubMed Web of Science ®Google Scholar
• Roos-Hesselink J, Baris L, Johnson M, et al. Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry of Pregnancy and Cardiac disease (ROPAC). Eur Heart J. 2019;40(47):3848–3855. DOI:10.1093/eurheartj/ehz136
   PubMed Web of Science ®Google Scholar
• Kiely DG, Condliffe R, Webster V, et al. Improved survival in pregnancy and pulmonary hypertension using a multiprofessional approach. BJOG. 2010;117(5):565–574. DOI:10.1111/j.1471-0528.2009.02492.x
   PubMed Web of Science ®Google Scholar
• Sharma B, Sikka P, Chopra S, et al. Pregnancy in Eisenmenger syndrome: a case series from a tertiary care hospital of Northern India. Cardiol Young. 2023;1–5. DOI:10.1017/S1047951122004152
   Web of Science ®Google Scholar
• Wilamarta KV, Yuniadi Y, Rachmat J, et al. Adult congenital cardiac surgery in Indonesia. Cardiol Young. 2011;21(6):639–645. DOI:10.1017/S1047951111000552
   PubMed Web of Science ®Google Scholar
• Duan R, Xu X, Wang X, et al. Pregnancy outcome in women with Eisenmenger’s syndrome: a case series from west China. Bmc Pregnancy Childbirth. 2016;16(1):356. DOI:10.1186/s12884-016-1153-z
   PubMedGoogle Scholar
• Hasan B, Hansmann G, Budts W, et al. Challenges and special aspects of pulmonary hypertension in middle- to low-income regions. J Am Coll Cardiol. 2020;75(19):2463–2477. DOI:10.1016/j.jacc.2020.03.047
   PubMed Web of Science ®Google Scholar
• Bonnin M, Mercier FJ, Sitbon O, et al. Severe pulmonary hypertension during pregnancy: mode of delivery and anesthetic management of 15 consecutive cases. Anesthesiology. 2005;102(6):1133–1137. DOI:10.1097/00000542-200506000-00012
   PubMed Web of Science ®Google Scholar
• Constantine A, Tulloh RMR, Turquet R, et al. PAH-CHD: transition to adulthood. J Congenit Cardiol. 2020;4(S1):9. DOI:10.1186/s40949-020-00043-x
   Google Scholar
• Olsson KM, Channick R. Pregnancy in pulmonary arterial hypertension. Eur Respir Rev. 2016;25(142):431–437.
   PubMed Web of Science ®Google Scholar
• Olsson KM, Jais X. Birth control and pregnancy management in pulmonary hypertension. Semin Respir Crit Care Med. 2013;34(05):681–688.
   PubMedGoogle Scholar
• Thorne S, Nelson-Piercy C, MacGregor A, et al. Pregnancy and contraception in heart disease and pulmonary arterial hypertension. J Fam Plann Reprod Health Care. 2006;32(2):75–81. DOI:10.1783/147118906776276486
   PubMedGoogle Scholar
• Chen W, Luo J, Chen J, et al. Effect of multidisciplinary team (MDT) centred on pregnant women with pulmonary hypertension on treatment and outcomes of pregnancy. BMC Pulm Med. 2023;23(1):62. DOI:10.1186/s12890-023-02355-1
   PubMed Web of Science ®Google Scholar
• Easterling TR, Ralph DD, Schmucker BC. Pulmonary hypertension in pregnancy: treatment with pulmonary vasodilators. Obstet Gynecol. 1999;93(4):494–498.
   PubMed Web of Science ®Google Scholar
• Krishnan S, Fricke EM, Cordoba M, et al. Pulmonary hypertension complicating pregnancy. Curr Pulmonol Rep. 2021;10(2):71–83. DOI:10.1007/s13665-021-00275-1
   Web of Science ®Google Scholar
• Wylie BJ, Epps KC, Gaddipati S, et al. Correlation of transthoracic echocardiography and right heart catheterization in pregnancy. J Perinat Med. 2007;35(6):497–502. DOI:10.1515/JPM.2007.133
   PubMed Web of Science ®Google Scholar
• Hoeper MM, Lee SH, Voswinckel R, et al. Complications of right heart catheterization procedures in patients with pulmonary hypertension in experienced centers. J Am Coll Cardiol. 2006;48(12):2546–2552. DOI:10.1016/j.jacc.2006.07.061
   PubMed Web of Science ®Google Scholar
• Chen Y, Shlofmitz E, Khalid N, et al. Right heart catheterization-related complications: a review of the literature and best practices. Cardiol Rev. 2020;28(1):36. DOI:10.1097/CRD.0000000000000270
   PubMed Web of Science ®Google Scholar
• Prokšelj K, Brida M. Cardiovascular imaging in pregnancy. Int J Cardiol Congenit Heart Dis. 2021;5:100235.
   Google Scholar
• Hemnes AR, Kiely DG, Cockrill BA, et al. Statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research Institute. Pulm Circ. 2015;5(3):435–465. DOI:10.1086/682230
   PubMed Web of Science ®Google Scholar
• Dimopoulos K, Condliffe R, Tulloh RMR, et al. Echocardiographic screening for pulmonary hypertension in congenital heart disease. J Am Coll Cardiol. 2018;72(22):2778–2788. DOI:10.1016/j.jacc.2018.08.2201
   PubMed Web of Science ®Google Scholar
• Hameed A, Ecklund H, Rumney P, et al. B-type natriuretic peptide levels in normal pregnancy. Am J Obstet Gynecol. 2006;195(6):S81. DOI:10.1016/j.ajog.2006.10.257
   Web of Science ®Google Scholar
• Hoeper MM, Pausch C, Olsson KM, et al. COMPERA 2.0: a refined four-stratum risk assessment model for pulmonary arterial hypertension. Eur Respir J. 2022;60(1):2102311. DOI:10.1183/13993003.02311-2021
   PubMed Web of Science ®Google Scholar
• Bamigboye AA, Hofmeyr GJ. Interventions for leg edema and varicosities in pregnancy. What Evidence? Eur J Obstet Gynecol Reprod Biol. 2006;129(1):3–8.
   PubMed Web of Science ®Google Scholar
• Warnes CA. Pregnancy and pulmonary hypertension. Int J Cardiol. 2004;97:11–13.
   PubMed Web of Science ®Google Scholar
• Anjum H, Surani S. Pulmonary hypertension in pregnancy: a review. Med (Kaunas). 2021;57(3):259.
   PubMed Web of Science ®Google Scholar
• Curry R, Fletcher C, Gelson E, et al. Pulmonary hypertension and pregnancy—a review of 12 pregnancies in nine women. BJOG: Int J Obstet Gynaecol. 2012;119(6):752–761. DOI:10.1111/j.1471-0528.2012.03295.x
   PubMed Web of Science ®Google Scholar
• Reducing the risk of thrombosis and embolism during pregnancy and the puerperium (Green-top Guideline No. 37a) [Internet]. RCOG. [cited 2023 Jan 27]. Available from: https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/reducing-the-risk-of-thrombosis-and-embolism-during-pregnancy-and-the-puerperium-green-top-guideline-no-37a/.
   Google Scholar
• Pitts JA, Crosby WM, Basta LL. Eisenmenger’s syndrome in pregnancy: does heparin prophylaxis improve the maternal mortality rate? Am Heart J. 1977;93(3):321–326.
   PubMed Web of Science ®Google Scholar
• de Raaf MA, Beekhuijzen M, Guignabert C, et al. Endothelin-1 receptor antagonists in fetal development and pulmonary arterial hypertension. Reprod Toxicol. 2015;56:45–51.
   PubMed Web of Science ®Google Scholar
• Burks M, Stickel S, Galiè N. Pulmonary arterial hypertension: combination therapy in practice. Am J Cardiovasc Drugs. 2018;18(4):249–257.
   PubMed Web of Science ®Google Scholar
• Elliot CA, Stewart P, Webster VJ, et al. The use of iloprost in early pregnancy in patients with pulmonary arterial hypertension. Eur Respir J. 2005;26(1):168–173. DOI:10.1183/09031936.05.00128504
   PubMed Web of Science ®Google Scholar
• Bendayan D, Hod M, Oron G, et al. Pregnancy outcome in patients with pulmonary arterial hypertension receiving prostacyclin therapy. Obstet Gynecol. 2005;106(5):1206. DOI:10.1097/01.AOG.0000164074.64137.f1
   PubMed Web of Science ®Google Scholar
• Goland S, Tsai F, Habib M, et al. Favorable outcome of pregnancy with an elective use of epoprostenol and sildenafil in women with severe pulmonary hypertension. CRD. 2010;115(3):205–208. DOI:10.1159/000287638
   Google Scholar
• Ward RM, Beachy JC. Neonatal complications following preterm birth. BJOG: Int J Obstet Gynaecol. 2003;110:8–16.
   PubMed Web of Science ®Google Scholar
• Kamp JC, Kaisenberg CV, Greve S, et al. Pregnancy in pulmonary arterial hypertension: midterm outcomes of mothers and offspring. J Heart Lung Transplant. 2021;40(3):229–233. DOI:10.1016/j.healun.2020.12.002
   PubMed Web of Science ®Google Scholar
• Olofsson C, Bremme K, Forssell G, et al. Cesarean section under epidural ropivacaine 0.75% in a parturient with severe pulmonary hypertension. Acta Anaesthesiol Scand. 2001;45(2):258–260. DOI:10.1034/j.1399-6576.2001.450220.x
   PubMed Web of Science ®Google Scholar
• O’Hare R, McLoughlin C, Milligan K, et al. Anaesthesia for caesarean section in the presence of severe primary pulmonary hypertension. Br J Anaesth. 1998;81(5):790–792. DOI:10.1093/bja/81.5.790
   PubMed Web of Science ®Google Scholar
• Monnery L, Nanson J, Charlton G. Primary pulmonary hypertension in pregnancy; a role for novel vasodilators. Br J Anaesth. 2001;87(2):295–298.
   PubMed Web of Science ®Google Scholar
• Tanaka H. Anesthetic and circulatory management of patients with pulmonary hypertension. J of Japan Soc Clin Anesth. 2020;40:520–526.
   Google Scholar
• Pieper PG. The pregnant woman with heart disease: management of pregnancy and delivery. Neth Heart J. 2012;20(1):33–37.
   PubMed Web of Science ®Google Scholar
• Blaise G, Langleben D, Hubert B. Pulmonary arterial hypertension: pathophysiology and anesthetic approach. Anesthesiology. 2003;99(6):1415–1432.
   PubMed Web of Science ®Google Scholar
• Abid Memon H, Safdar Z, Goodarzi A. Use of extracorporeal membrane oxygenation in postpartum management of a patient with pulmonary arterial hypertension. Case Rep Pulmonol. 2018;2018:7031731.
   PubMedGoogle Scholar
• Agerstrand C, Abrams D, Biscotti M, et al. Extracorporeal membrane oxygenation for cardiopulmonary failure during pregnancy and postpartum. Ann Thorac Surg. 2016;102(3):774–779. DOI:10.1016/j.athoracsur.2016.03.005
   PubMed Web of Science ®Google Scholar
• Joint Formulary Committee. British national formulary (online) London: bmj group and pharmaceutical press [Internet]. [cited 2023 Jan 18]. Available from: http://www.medicinescomplete.com
   Google Scholar