title: Favorable outcome of pregnancy with an elective use of epoprostenol and sildenafil in women with severe pulmonary hypertension.
abstract: BACKGROUND
  Pulmonary hypertension carries significant maternal and fetal risk during pregnancy and the postpartum period. As maternal mortality is high, specific targeted therapy for pulmonary hypertension may be required during pregnancy.
  
  
  METHODS
  We describe 2 pregnant patients who presented with severe secondary pulmonary arterial hypertension during their last trimester. They were electively treated in the late antepartum and early postpartum periods with sildenafil and intravenous epoprostenol and successfully delivered healthy infants via cesarean section without postpartum complications.
  
  
  CONCLUSIONS
  Although pulmonary hypertension is associated with a risk of maternal mortality and most women are advised against pregnancy, new therapies may improve the outcome of pregnancy in patients with pulmonary hypertension.
authors.affiliation: Department of Medicine, Division of Cardiology and Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
authors.forename: Sorel
authors.initials: S
authors.lastname: Goland
authors.forename: Fausen
authors.initials: F
authors.lastname: Tsai
authors.forename: Munira
authors.initials: M
authors.lastname: Habib
authors.forename: Munir
authors.initials: M
authors.lastname: Janmohamed
authors.forename: T Murphy
authors.initials: TM
authors.lastname: Goodwin
authors.forename: Uri
authors.initials: U
authors.lastname: Elkayam
mesh_terms: D000328:Adult; D002585:Cesarean Section; D004359:Drug Therapy, Combination; D011464:Epoprostenol / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D007231:Infant, Newborn; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D011687:Purines / Q000009:adverse effects / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013246:Sterilization, Tubal; D013450:Sulfones / Q000009:adverse effects / Q000627:therapeutic use*; D014655:Vascular Resistance / Q000187:drug effects; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate; D011464:Epoprostenol