Maternal and Neonatal Outcomes in Pregnancy Complicated with Pulmonary Hypertension

Abstract

Background: Pulmonary hypertension (PH) is a life-threatening disease with significant maternal morbidity and mortality. Methods: To assess pregnancy and neonatal outcomes and determine the risk factors for adverse maternal and neonatal outcomes in women with pulmonary hypertension (PH), a retrospective analysis was carried out examining 71 pregnancies in patients with PH who delivered at a tertiary care center in West China between January 2011 and May 2016. Results: One pregnancy resulted in spontaneous abortion and six resulted in terminated abortions. Cardiac complications were encountered in 16.9% including three maternal mortalities. At least one pregnancy complication occurred in 28.2% of all the pregnancies. Diagnosis after the third trimester, severe PH and/or right ventricular systolic dysfunction were predictive of adverse fetal/neonatal events. A history of prior cardiac events and right ventricular systolic dysfunction and/or baseline New York Heart Association (NYHA) class III or IV were the main predictive factors of adverse maternal cardiac events. Conclusions: In our study, we found that PH poses high risks for maternal and fetal morbidity and mortality. A detailed pre-pregnancy baseline assessment is strongly recommended in women with PH to identify those with the highest risk and subsequently guide clinical management.