Key result
Pregnancy in women with severe pulmonary hypertension carried a 28% maternal mortality rate, with NYHA cardiac function grade III-IV being useful in predicting the risk of mortality.
Why the study?
Pregnancy poses significant maternal and fetal risks in patients with severe PH, motivating an evaluation of maternal-fetal outcomes and their influencing factors.
Observational (n=25)
No
Pregnancy in women with severe pulmonary hypertension carries a 28% mortality risk, strongly supporting recommendations for contraception in this population.
Answers are grounded in this paper and cite their sources.
Severe PH pregnancy outcomes remain high-risk; retrospective data leaves open need for prospective risk-stratification studies.
Objective: Pregnancy is not recommended for patients with severe pulmonary hypertension (PH) due to the significant risks it poses to both the mother and fetus. The objective of this study is to describe the maternal-fetal outcomes in pregnant women with PH and identify the factors that influence these outcomes. Method: This retrospective study analyzed clinical data from 25 patients with severe PH who were admitted to our hospital between January 2018 and December 2022. The data we used came from a public general hospital in Fujian Province. Results: The mean systolic pulmonary artery pressure (sPAP) of 25 patients was 105.12 22.70 mmHg. All patients had received one or more multidisciplinary team (MDT) treatments before terminating their pregnancies. Among the pregnant women, four experienced a pulmonary hypertensive crisis (PHC), seven had heart failure, and one had postpartum hemorrhage (PPH). Among them, seven (28%) pregnant women died primarily due to heart failure and PHC. Among the fetal outcomes, twelve resulted in therapeutic abortion, and eleven resulted in preterm birth. Among the perinatal complications, eleven infants (84.6%) were born prematurely, six infants (46.2%) experienced neonatal asphyxia, eight infants (61.5%) had low birth weight, and two infants (15.4%) died during the perinatal period. According to the etiology, seven individuals had idiopathic pulmonary arterial hypertension (iPAH), ten had pulmonary arterial hypertension associated with congenital heart disease (CHD-PAH), six had pulmonary hypertension associated with left heart disease (LDH-PH), and two had pulmonary arterial hypertension caused by other diseases (oPAH). The sPAP levels of iPAH and CHD-PAH were significantly higher than those of LDH-PH and oPAH (p < 0.05). Additionally, the gestational weeks of LDH-PH were higher than those of iPAH (p < 0.05). The number of patients with New York Heart Association (NYHA) heart function grade III-V was higher in the death group compared to the non-death group (p < 0.05). Conclusion: Pregnancy in women with severe PH carries a high risk of mortality. Therefore, contraception is strongly recommended for these women. NYHA cardiac function grade III-IV was useful in predicting the risk of mortality.
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Dai et al. (2023) conducted an observational in Severe pulmonary hypertension in pregnancy (n=25). Severe pulmonary hypertension was evaluated on Maternal mortality. Pregnancy in women with severe pulmonary hypertension carried a 28% maternal mortality rate, with NYHA cardiac function grade III-IV being useful in predicting the risk of mortality.
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