Pregnancy outcome in patients with pulmonary arterial hypertension receiving prostacyclin therapy.
BACKGROUND
Pregnancy is contraindicated in cases of pulmonary hypertension, a highly morbid disease affecting young women of childbearing age.


METHODS
We describe the pregnancies of 3 patients with pulmonary arterial hypertension (idiopathic, Eisenmenger syndrome, and related to systemic lupus erythematosus). They received epoprostenol and low-molecular-weight heparin throughout pregnancy. The patient with Eisenmenger syndrome started epoprostenol in gestational week 16. Cesarean delivery under general anesthesia was performed at 28-33 weeks of gestation; early delivery was necessary in the patient with Eisenmenger syndrome because of fetal growth restriction. All deliveries were uneventful, and birth weights were 1,700, 1,500, and 795 g. There were no postpartum complications.


CONCLUSIONS
Pregnancy in women with pulmonary hypertension should still be considered high risk for both mother and child, but stable patients on epoprostenol may successfully complete pregnancy.
Bendayan
Daniele
D
Pulmonary Institute, the Perinatal Division and WHO Collaborating Center for Perinatal Care, Department of Obstetrics and Gynecology, Beilinson Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Hod
Moshe
M
Oron
Galia
G
Sagie
Alik
A
Eidelman
Leonid
L
Shitrit
David
D
Kramer
Mordechai R
MR
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002585:Cesarean Section; D004541:Eisenmenger Complex / Q000150:complications / Q000188:drug therapy; D011464:Epoprostenol / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000188:drug therapy; D007231:Infant, Newborn; D007234:Infant, Premature; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy; D008297:Male; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011256:Pregnancy Outcome
D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D011464:Epoprostenol