title: Pulmonary hypertension and pregnancy--a review of 12 pregnancies in nine women.
abstract: OBJECTIVE
  To report outcomes in a recent series of pregnancies in women with pulmonary hypertension (PH).
  
  
  METHODS
  Retrospective case note review.
  
  
  METHODS
  Tertiary referral unit (Chelsea and Westminster and Royal Brompton Hospitals).
  
  
  METHODS
  Twelve pregnancies in nine women with PH between 1995 and 2010.
  
  
  METHODS
  Multidisciplinary review of case records.
  
  
  METHODS
  Maternal and neonatal mortality and morbidity.
  
  
  RESULTS
  There were two maternal deaths (1995 and 1998), one related to pre-eclampsia and one to arrhythmia. Maternal morbidity included postpartum haemorrhage (five cases), and one post-caesarean evacuation of a wound haematoma. There were no perinatal deaths, nine live births and three first-trimester miscarriages. Mean birthweight was 2197 g, mean gestational age was 34 weeks (range 26-39), and mean birthweight centile was 36 (range 5-60). Five babies required admission to the neonatal intensive care unit, but were all eventually discharged home. All women were delivered by caesarean section (seven elective and two emergency deliveries), under general anaesthetic except for one emergency and one elective caesarean performed under regional block.
  
  
  CONCLUSIONS
  Maternal and fetal outcomes for women with PH may be improving. However, the risk of maternal mortality remains significant, so that early and effective counselling about contraceptive options and pregnancy risks should continue to play a major role in the management of such women when they reach reproductive maturity.
authors.affiliation: Academic Department of Obstetrics and Gynaecology, Faculty of Medicine, Imperial College London, Chelsea and Westminster NHS Foundation Trust, London, UK. r.curry@imperial.ac.uk
authors.forename: R A
authors.initials: RA
authors.lastname: Curry
authors.forename: C
authors.initials: C
authors.lastname: Fletcher
authors.forename: E
authors.initials: E
authors.lastname: Gelson
authors.forename: M A
authors.initials: MA
authors.lastname: Gatzoulis
authors.forename: M
authors.initials: M
authors.lastname: Woolnough
authors.forename: N
authors.initials: N
authors.lastname: Richards
authors.forename: L
authors.initials: L
authors.lastname: Swan
authors.forename: P J
authors.initials: PJ
authors.lastname: Steer
authors.forename: M R
authors.initials: MR
authors.lastname: Johnson
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000401:mortality; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D008428:Maternal Mortality; D011225:Pre-Eclampsia / Q000401:mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult