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Obstetrics & Gynecology 2005;106:1206-1210
© 2005 by The American College of Obstetricians and Gynecologists
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Right arrow Medical complications of pregnancy

CASE REPORTS

Pregnancy Outcome in Patients With Pulmonary Arterial Hypertension Receiving Prostacyclin Therapy

Daniele Bendayan, MD1, Moshe Hod, MD2, Galia Oron, MD2, Alik Sagie, MD3, Leonid Eidelman, MD4, David Shitrit, MD1 and Mordechai R. Kramer, MD1

From the 1Pulmonary Institute, 2the Perinatal Division and WHO Collaborating Center for Perinatal Care, Department of Obstetrics and Gynecology, 3the Cardiology Division and Echocardiography Unit, and 4the Department of Anesthesia, Beilinson Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

BACKGROUND: Pregnancy is contraindicated in cases of pulmonary hypertension, a highly morbid disease affecting young women of childbearing age.

CASES: 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.

CONCLUSION: 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.




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