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March 14, 2019BJOG An International Journal of Obstetrics & GynaecologyOpen Access

There were 4 maternal deaths (3 with Eisenmenger syndrome), heart failure complicated 6.3% of pregnancies, and fetal growth restriction occurred in 26.3%; morbidity was significantly increased with cyanotic cardiac lesions or RVSP >70 mmHg.

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Why the study?

To evaluate maternal complications and pregnancy outcomes in women with pulmonary hypertension attending a tertiary centre in south India.

Population

81 pregnancies in 73 women with pulmonary hypertension

Comparison

Outcomes compared by presence vs absence of cyanosis and right ventricular systolic pressure levels

Design

Single-centre retrospective observational study

Authors

AKAnish KeepanasserilAPAA PillaiJSJ. Yavana Suriya

Discussion

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Overview

Persistent maternal mortality in PH pregnancies, especially Eisenmenger; supports tertiary multidisciplinary care while leaving optimal strategies open.

Key Points

  • To evaluate maternal complications and pregnancy outcomes in women with pulmonary hypertension managed at a tertiary healthcare center in South India.
  • Retrospective observational study reviewing medical records of pregnant women with pulmonary hypertension at a single tertiary care center in South India.
  • Analyzed clinical courses across 81 pregnancies in 73 women, evaluating echocardiographic diagnoses, medications, labor, delivery, and postpartum follow-up.
  • Stratified and compared maternal and fetal outcomes based on the presence of cyanosis and right ventricular systolic pressure levels.
  • Most patients had pulmonary hypertension secondary to congenital heart disease (80.8%), with 17.8% presenting with Eisenmenger syndrome and 31.3% receiving sildenafil.
  • Four maternal deaths occurred overall, three of which were in patients with Eisenmenger syndrome; heart failure complicated 6.3% and fetal growth restriction occurred in 26.3% of pregnancies.
  • Maternal morbidity increased significantly in women who had cyanotic cardiac lesions or right ventricular systolic pressure exceeding 70 mmHg.

Structured PICO

P
Population
73 pregnant women (81 pregnancies) with pulmonary hypertension (80.8% secondary to congenital heart disease, 17.8% Eisenmenger syndrome) attending a tertiary centre in South India.
O
Outcome
Maternal mortality, occurrence of complications such as heart failure, fetal growth restrictionhard clinical

Pregnancy in women with pulmonary hypertension, particularly Eisenmenger syndrome, carries significant maternal mortality and morbidity, highlighting the need for multidisciplinary care.

Cite This Study

Keepanasseril et al. (2019) studied this question.

synapsesocial.com/papers/6a761ca97d7eb453cc708792https://doi.org/10.1111/1471-0528.15681
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pulmonary Hypertension in Pregnancy2017 · 182 citations
  2. 2Pregnancy outcomes in patients with pulmonary arterial hypertension associated with congenital heart disease2016 · 101 citations
  3. 3Pulmonary Hypertension and Pregnancy Outcomes: Data from the Registry Of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology2016 · 277 citations
  4. 4Outcome of Pulmonary Vascular Disease in Pregnancy: A Systematic Overview From 1978 Through 19961998 · 682 citations
  5. 5Pregnancy Outcome in Patients With Pulmonary Arterial Hypertension Receiving Prostacyclin Therapy2005 · 107 citations