Key result
Strict contraception is recommended for patients with pulmonary arterial hypertension, but for those who continue pregnancy, early multidisciplinary management and targeted therapies are essential to mitigate high maternal and fetal risks.
Why the study?
Pregnant individuals with pulmonary arterial hypertension face high risks of maternal and perinatal mortality due to physiological changes straining the right ventricle, necessitating review of pre-conception and therapeutic strategies.
Pregnancy in patients with PAH carries a high risk of maternal mortality, necessitating strict contraception, multidisciplinary care, and individualized pharmacological management if pregnancy occurs.
Prioritizes contraception counseling in PAH; leaves open optimal targeted regimens for continuing pregnancies.
Pregnant individuals with pulmonary arterial hypertension (PAH) have significantly high risks of maternal and perinatal mortality. Profound changes in plasma volume, cardiac output and systemic vascular resistance can all increase the strain being placed on the right ventricle, leading to heart failure and cardiovascular collapse. Given the complex network of opposing physiological changes, strict contraception and reduction of hemodynamic fluctuations during pregnancy are important methods of minimizing the risk of maternal mortality and improving the outcomes following pregnancy. In this review, we discuss the recent research progress into pre-conception management and the various therapeutic strategies for pregnant individuals with PAH.
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Zhang et al. (2022) conducted a review in Pulmonary arterial hypertension in pregnancy. Multidisciplinary management and targeted PAH therapies was evaluated. Strict contraception is recommended for patients with pulmonary arterial hypertension, but for those who continue pregnancy, early multidisciplinary management and targeted therapies are essential to mitigate high maternal and fetal risks.
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