Inhaled Nitric Oxide for Primary Pulmonary Hypertension in Pregnancy

In Brief BACKGROUND Primary pulmonary hypertension is a rare and dangerous entity in pregnancy. Previous studies have found a 35–50% maternal mortality rate in the peripartum period. To date, most reports have described treatment of these patients with diuretics, digoxin, and calcium-channel blockers. CASE We describe the successful treatment of a primigravida with severe primary pulmonary hypertension. We used elective intubation before labor, inhaled nitric oxide therapy, and assisted vaginal delivery with epidural anesthesia that resulted in a viable infant and survival of the mother. CONCLUSION Nitric oxide can be used to successfully treat primary pulmonary hypertension in pregnancy. A pregnant patient with primary pulmonary hypertension was treated successfully in the peripartum period using elective intubation, mechanical ventilation, and inhaled nitric oxide.