title: Successful maternal-foetal outcome using nitric oxide and sildenafil in pulmonary hypertension with atrial septal defect and HIV infection.
abstract: Pulmonary hypertension associated with pregnancy carries a poor prognosis. We describe successful maternal-foetal outcome for a 30-year-old woman who was found to have severe pulmonary hypertension, human immunodeficiency virus (HIV) and an atrial septal defect. Prior to delivery, she was managed with subcutaneous enoxaparine, sildenafil, nitric oxide, careful maintenance of a euvolemic status and antiretroviral therapy. She was planned for an elective Caesarean section to reduce the risk of maternal-foetal HIV transmission, but went into labour in the coronary care unit. During delivery, antibiotic prophylaxis was given, although there was insufficient time for intravenous zidovudine. Peripartum, the patient was continued on nitric oxide and subcutaneous enoxaparine. She was eventually weaned off the nitric oxide and recovered well.
authors.affiliation: National University Heart Centre Singapore, National University Health System, 1E Kent Ridge Road, Level 9, Singapore.
authors.forename: W P
authors.initials: WP
authors.lastname: Ng
authors.forename: W L
authors.initials: WL
authors.lastname: Yip
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D017984:Enoxaparin / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000517:prevention & control; D006344:Heart Septal Defects, Atrial; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D009569:Nitric Oxide / Q000378:metabolism / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy; D011251:Pregnancy Complications, Infectious / Q000628:therapy; D011256:Pregnancy Outcome; D011687:Purines / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D000925:Anticoagulants; D017984:Enoxaparin; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D009569:Nitric Oxide; D015215:Zidovudine; D000068677:Sildenafil Citrate