Multidisciplinary management of pulmonary arterial hypertension during pregnancy in 6 women (9 pregnancies) resulted in 7 term births of healthy neonates and 2 first-trimester terminations.
Observational (n=6)
No
What are the outcomes of multidisciplinary management for pregnant women with pulmonary arterial hypertension?
Multidisciplinary management of pregnant women with PAH, including regional anaesthesia and consideration of term vaginal birth, can result in safe delivery and healthy neonates.
BACKGROUND: Pulmonary arterial hypertension (PAH) is a high-risk condition during pregnancy, with recent literature describing mortality rates of up to 23%. AIM: To describe the course and outcomes of pregnancy for women with PAH in a major Australian metropolitan referral centre over a 15-year period. METHODS: Retrospective review of medical records of all pregnant women with PAH over the period 2005-2020. RESULTS: We report the outcomes of nine pregnancies in six women. In five women, seven pregnancies proceeded to term with birth of a healthy neonate, five vaginal births and two caesareans. Two women opted for a termination of pregnancy in the first trimester following counselling. The planning of care and patient-centred decision-making was individually tailored by a multidisciplinary team. The pulmonary hypertension clinic provided specialist support including the management of pulmonary vasodilators. All women who delivered a live offspring received neuraxial anaesthesia. CONCLUSIONS: Women with this condition are ideally managed in a centre with expertise in PAH; counselling regarding the risks is imperative. Regional anaesthesia, irrespective of the mode of delivery, facilitated safe delivery and improved patient experience. The option of aiming for a term vaginal birth needs to be considered in these complex women.
Boyers et al. (Tue,) conducted a observational in Pulmonary arterial hypertension in pregnancy (n=6). Multidisciplinary management was evaluated on Course and outcomes of pregnancy. Multidisciplinary management of pulmonary arterial hypertension during pregnancy in 6 women (9 pregnancies) resulted in 7 term births of healthy neonates and 2 first-trimester terminations.