Severe pulmonary artery hypertension can be an initial, life-threatening presentation of systemic lupus erythematosus in pregnancy, requiring multidisciplinary management including pregnancy termination and targeted medical therapy.
A 33-year-old G2 P1001 female at 13 weeks of gestation presented with dyspnea, tachycardia, and hypotension. Initial assessment revealed cardiogenic shock and acute respiratory failure caused by extremely severe pulmonary artery hypertension (PAH). Multidisciplinary efforts led to the diagnosis of severe PAH as an initial manifestation of systemic lupus erythematosus (SLE). Team care included gestational termination via dilation and curettage (D&C), followed by corticosteroids and vasodilator therapy, with excellent clinical and hemodynamic outcomes.
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Hoang et al. (2022) studied this question.
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