Mortality Prevention in Pregnancy With Pulmonary Arterial Hypertension

Olivia Handayani,Setyasih Anjarwani,Mohammad Saifur Rohman,Ardian Rizal

doi:10.21776/ub.hsj.2020.001.04.07

Olivia Handayani, Setyasih Anjarwani + Show 2 more

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https://doi.org/10.21776/ub.hsj.2020.001.04.07

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Journal: Heart Science Journal	Publication Date: Dec 23, 2020
License type: cc-by

Affiliation: University of Brawijaya

Abstract

Background : Pulmonary hypertension (PH) is a global disease that affects all age groups and progresses in later years. Pregnancy with PH has a poor prognosis, and it is because of delayed diagnosis or even undiagnosed. PH gives high-risk to the mother and fetus; therefore, arranging a multidisciplinary team for pregnancy and delivery management is required. Objective : This case report was structured to emphasize mortality prevention in pregnancy with PH. Case : A 23-year-old female was admitted to the hospital with a chief complaint of dyspnea at rest. She was 34-week pregnant pregnancy and previously had a history of abortion with similar symptoms. After conducting some examinations, the patient was diagnosed with pulmonary hypertension. We planned for lung maturation for the fetus, scheduled termination, delivery method, and post-delivery care. The fetus was dead intra-uterine on day 5 of care, and the mother passed away 24 hours later. Conclusion : In summary, pregnancy was not advised in women with pulmonary hypertension. The collaboration and management by a multidisciplinary team are essential to improve outcomes if the pregnancy was still wanted.

Highlights

Pregnancy with pulmonary hypertension (PH) in women is rare and known to be associated with high morbidity and mortality
We planned for lung maturation for the fetus, scheduled termination, delivery method, and post-delivery care
In summary, pregnancy was not advised in women with pulmonary hypertension

Summary

Introduction

Pregnancy with pulmonary hypertension (PH) in women is rare and known to be associated with high morbidity and mortality. PH is considered a contraindication for pregnancy; some women have known to be pregnant when they are newly diagnosed with PH. They are usually advised for pregnancy termination, the termination itself has its own risks.[1,2,3]. Current guidelines strongly advise to avoid pregnancy and share some recommendations on how to treat PH in pregnancy.[3].

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