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Obstetrics & Gynecology 2001;98:895-898
© 2001 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Inhaled Nitric Oxide for Primary Pulmonary Hypertension in Pregnancy

Garrett K. Lam, MD, Renae E. Stafford, MD, John Thorp, MD, Kenneth J. Moise, Jr, MD and Bruce A. Cairns, MD

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, and the Division of Critical Care, Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina

Address reprint requests to: Garrett Lam, Division of Maternal-Fetal Medicine, 214 MacNider Building, CB7516, Chapel Hill, North Carolina 27599; E-mail: garrett_lam{at}med.unc.edu.

BACKGROUND: Primary pulmonary hypertension is a rare and dangerous entity in pregnancy. Previous studies have found a 35–50% maternal mortality rate in the peripartum period. To date, most reports have described treatment of these patients with diuretics, digoxin, and calcium-channel blockers.

CASE: We describe the successful treatment of a primigravida with severe primary pulmonary hypertension. We used elective intubation before labor, inhaled nitric oxide therapy, and assisted vaginal delivery with epidural anesthesia that resulted in a viable infant and survival of the mother.

CONCLUSION: Nitric oxide can be used to successfully treat primary pulmonary hypertension in pregnancy.




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