Pregnant patients with pulmonary hypertension had 16.7% fetal mortality, 4% maternal mortality, and 67.75% preterm delivery, with 43.18% diagnosed during pregnancy.
Pregnancy in patients with pulmonary hypertension is associated with high rates of preterm birth (67.75%) and fetal mortality (16.67%), highlighting the significant risks in this population.
Abstract OBJECTIVES To evaluate the clinical characteristics of patients (p) with Pulmonary Hypertension (PH) and pregnancy (pre) in our population. Methods Multicenter, analytical, prospective study that included p with PH and pre (diagnosis of PH prior to or during pre) from the Argentine PH registry. Demographic, clinical, echocardiographic (eco), hemodynamic, and therapeutic data were collected. The risk was defined by European guidelines 2022 prior to pregnancy. The characteristics of the pre, the newborn and type of delivery were analyzed. Preterm pre was defined as 37 weeks. Categorical variables were expressed as percentages and continuous variables as mean or medians with respect to standard deviation (SD) or interquartile range (IQR). Results 44 p were included, mean age of 32 years (±8.3), with a history of PH in 56.2% and diagnosis during pre in 43.18%. Group I 95.45% and IV 4.55%. Table 1 shows baseline characteristic and treatments during pre. Gestation time was 30 weeks (QIR 15-35), term pre 31.25% and preterm 67.75%. Newborn weight: 2780 gr (DS 623.9) and 25% ≤ 2100 grams. Type of delivery: Vaginal 24.3% and cesarean 75.68% (urgency 27%). Fetal mortality 16.67% and maternal mortality 4%. Maternal hospitalization 7.5 days (6-12). Eco parameters observed: impaired RVFS 58.8% (severe 14.7%, moderate 26.47% and mild 17.65%), TAPSE 17.59 mm (±4.78), FAC 37.62% (±16.07), TVR 4.08 (3.44-4.6) and pericardial effusion in 25%. The hemodynamic variables were: RAP 9 (5-15), mPAP 59 (52-65); CG 4.8 (3.7-6.8),CI 2.6 (2.28-3.5) and PVR 9.29 (6.4-12.88). Conclusions In our population with PH and pre we observed a high percentage of de novo diagnosis of PH (43.18%), of fetal mortality (16.67%),preterm pre and use of vaginal delivery (24.3%). Likewise, we detected a profile of major vascular compromise (mPAP and PVR) with preservation of RV function. This analysis of the ARGEN-HP registry forces us to obtain more information on this subpopulation and highlight the high rate of associated morbidity/ mortality.
Croome et al. (2025) studied this question. Pregnant patients with pulmonary hypertension had 16.7% fetal mortality, 4% maternal mortality, and 67.75% preterm delivery, with 43.18% diagnosed during pregnancy.