title: Pregnancy outcome in women with pulmonary arterial hypertension: single-center experience from India.
abstract: BACKGROUND
  A retrospective analysis of the records of all the patients of pulmonary arterial hypertension with pregnancy at AIIMS, New Delhi, India, to study maternal and perinatal outcome and to compare outcome between severe and mild pulmonary arterial hypertension.
  
  
  METHODS
  A retrospective analysis was carried out of 30 pregnancies in women with pulmonary arterial hypertension (PAH) who delivered at ≥ 28 weeks of gestation from July 2006 through July 2012 at a tertiary care center in India. Pulmonary artery blood pressure (PABP) during the first trimester of pregnancy or before pregnancy was considered to define PABP as severe or mild, with severe cases having systolic PABP >50 mmHg on echocardiography.
  
  
  RESULTS
  Out of 30 patients, 14 patients had severe PAH and 16 patients had mild PAH. Women with severe PAH had a significantly higher incidence of preterm delivery (11 vs. 3, P < 0.05), small for gestational age infants (10 vs. 2, P < 0.05) and cardiac complications (6 vs. 1, P < 0.05) compared to women with mild PAH. There was maternal mortality in a patient with Eisenmenger syndrome. In women with severe PAH and mild PAH, PABP increased in later pregnancy from 63.14 ± 7.6 to 71.57 ± 7.9 mmHg (P < 0.05) and from 40.37 ± 3.6 to 41.69 ± 4.1 mmHg (P < 0.05), respectively.
  
  
  CONCLUSIONS
  Pregnancy in women with severe PAH is associated with higher maternal morbidity and adverse fetal outcome compared to pregnancy in women with mild PAH.
authors: Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India. muralidraiims@gmail.com
authors: Murali
authors: M
authors: Subbaiah
authors: Sunesh
authors: S
authors: Kumar
authors: Kallol Kumar
authors: KK
authors: Roy
authors: Jai Bhagwan
authors: JB
authors: Sharma
authors: Neeta
authors: N
authors: Singh
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology; D062186:Arterial Pressure; D001724:Birth Weight; D002585:Cesarean Section; D004452:Echocardiography; D004541:Eisenmenger Complex / Q000150:complications; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D005865:Gestational Age; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D007194:India; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D010879:Piperazines / Q000627:therapeutic use; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000503:physiopathology; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000209:etiology; D011687:Purines / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate