Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Pulmonary Hypertension

Abstract

(Anesth Analg. 2024;138(5):1011–1019. doi: 10.1213/ANE.0000000000006523) Pulmonary hypertension (PHTN) conveys significant risk for morbidity and mortality during pregnancy leading to many patients being counseled against pregnancy or for termination should pregnancy occur. Despite this risk, some women do proceed with pregnancy beyond 25 weeks; however, information on these cases remains elusive and limited to case series or reports with small samples. Current recommendations surrounding delivery for women with PHTN recommend cesarean delivery (CD), but new evidence is showing that trial of labor in these circumstances is safe and that vaginal delivery (VD) may reduce associated rates of morbidity and mortality. This study assessed the association between mode of delivery and maternal morbidity in individuals with PHTN and pregnancies past 25 weeks of gestation, with a hypothesis that an intended VD has lower morbidity rates than intended CD.