Pulmonary Hypertension in Pregnancy

Debasree Banerjee; Corey E. Ventetuolo

doi:10.1055/s-0037-1602242

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2017; 38(02): 148-159
DOI: 10.1055/s-0037-1602242

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pulmonary Hypertension in Pregnancy

Debasree Banerjee

¹Division of Pulmonary, Critical Care, and Sleep, Rhode Island Hospital, Providence, Rhode Island

²Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island

,

Corey E. Ventetuolo

¹Division of Pulmonary, Critical Care, and Sleep, Rhode Island Hospital, Providence, Rhode Island

²Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island

³Health Services, Policy, and Practice, Brown University, Providence, Rhode Island

› Author Affiliations

Abstract

Pulmonary arterial hypertension (PAH) is a pulmonary vasculopathy associated with abnormal cardiopulmonary hemodynamics and a limited life expectancy due to right heart failure. Young women are preferentially affected. Women with PAH are at increased risk of complications and death during pregnancy for both the mother and the fetus. While it is not well characterized how changes in sex steroids and other hormones during pregnancy affect pulmonary hypertension, many expected systemic and heart–lung physiologic adaptations during gestation are poorly tolerated in women with PAH. Despite the approval of numerous therapies for PAH in recent years, pregnancy avoidance or early termination is still recommended in women with PAH because of poor outcomes. In this review, we will discuss physiologic and hormonal changes in pregnancy as they relate to pulmonary vascular disease and right heart function. We will review current consensus recommendations and outline the management of pregnancy in PAH when it does occur.

Keywords

pulmonary hypertension - pregnancy - right heart failure

Full Text

References

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