Management of Eisenmenger syndrome in pregnancy with sildenafil and L-arginine.
BACKGROUND
Eisenmenger syndrome in pregnancy may be a life-threatening disease despite recent additions to the treatment options.


METHODS
We present a woman with severe pulmonary hypertension due to Eisenmenger syndrome treated during pregnancy and delivery and postpartum with L-arginine and sildenafil to enhance the nitric oxide pathway. This combination was associated with significant improvement in the mother's clinical and hemodynamic condition and fetal well-being.


CONCLUSIONS
The concomitant use of sildenafil and L-arginine for the management of pulmonary hypertension in pregnancy, combined with multidisciplinary care, permitted a good outcome for the mother and her infant.
Lacassie
Héctor J
HJ
Pontificia Universidad Católica de Chile, Santiago, Chile.
Germain
Alfredo M
AM
Valdés
Gloria
G
Fernández
M Soledad
MS
Allamand
Francisco
F
López
Héctor
H
D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000037:antagonists & inhibitors*; D000328:Adult; D001120:Arginine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004541:Eisenmenger Complex / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology; D010348:Patient Care Team; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones
D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D001120:Arginine; D000068677:Sildenafil Citrate; D015106:3',5'-Cyclic-GMP Phosphodiesterases