Successful Anesthetic Management of Patients with Pulmonary Hypertension Undergoing Elective Cesarean Section: A Series of 5 Cases

The mortality rates of pulmonary hypertension complicating pregnancy remains high despite advances in treatment options. The normal physiological changes in pregnancy and labor combined with progressive increase in pulmonary vascular resistance may lead to cardiac decompensation in peri- and postpartum periods and is associated with high peripartum mortality. Therefore, prevention of pregnancy is still recommended in diagnosed cases of pulmonary hypertension. We report our experience in managing five cases of pulmonary hypertension undergoing elective cesarean delivery. All five patients had good maternal and neonatal outcomes and were discharged uneventfully on pulmonary vasodilators. Multidisciplinary team approach was associated with successful maternal and neonatal outcome in our cases. The obstetric anesthetists were integral members of the team and were introduced to the patients at the earliest. Early detection, treatment of pulmonary hypertension, risk stratification, and individualized perioperative plan are very important to ensure successful outcome.