Pregnancy in PAH remains high-risk and is contraindicated by guidelines, but for women who continue pregnancy, multidisciplinary care at specialized centers using approved PAH therapies (excluding teratogenic ERAs) can improve outcomes.
Continues to support counseling against pregnancy in PAH; leaves open whether specialized care can further improve outcomes.
Despite advanced therapies, maternal mortality in women with pulmonary arterial hypertension (PAH) remains high in pregnancy and is especially high during the post-partum period. However, recent data indicates that morbidity and mortality during pregnancy and after birth have improved for PAH patients. The current European Society of Cardiology/European Respiratory Society guidelines recommend that women with PAH should not become pregnant. Therefore, the risks associated with pregnancy must be emphasised and counselling offered to women at the time of PAH diagnosis and to women with PAH who become pregnant. Early termination should be discussed. Women who choose to continue with their pregnancy should be treated at specialised pulmonary hypertension centres with experience in managing PAH during and after pregnancy.
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Olsson et al. (2016) studied this question.
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