Pulmonary arterial hypertension in pregnant women (PAH). Update

E. Dantes, C. Toma, O.C. Arghir, P.A. Fildan, M. Mitran, M.M. Cîrstoiu, E. Brătilă

Rezumat: Pulmonary arterial hypertension (PAH) represents a substantial risk factor associated with high mortality in pregnant women, a reason why a pregnancy is a contraindication in patients who are diagnosed with this condition. Pathophysiological changes induced by pregnancy and childbirth have negative effects on the pulmonary vasculature and the right side of the heart. Young age of pregnant women, non-specific symptoms or asymptomatic forms, especially in early diagnosis of PAH, and lack of monitoring pregnancy may lead to confusion or misdiagnosis. In PAH patients, continuation of pregnancy involves establishing a specialist-run multi-disciplinary team for monitoring and assessing intrapartum delivery and postpartum management. Despite advances in PAH treatment, guidelines strongly discourage pregnancy in PAH patients. Successful outcome could be possible with experienced teams in a high-specialized Ob-Gyn delivery unit.
Cuvinte cheie: pulmonary arterial hypertension (PAH), pregnancy, delivery, PAH treatment, peri- and postnatal mortality.