Maternal medicine

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Pulmonary hypertension and pregnancy—a review of 12 pregnancies in nine women

  1. RA Curry1,
  2. C Fletcher2,
  3. E Gelson1,
  4. MA Gatzoulis2,
  5. M Woolnough3,
  6. N Richards3,
  7. L Swan2,
  8. PJ Steer1,
  9. MR Johnson1

Article first published online: 6 MAR 2012

DOI: 10.1111/j.1471-0528.2012.03295.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 119, Issue 6, pages 752–761, May 2012

Additional Information

How to Cite

Curry, R., Fletcher, C., Gelson, E., Gatzoulis, M., Woolnough, M., Richards, N., Swan, L., Steer, P. and Johnson, M. (2012), Pulmonary hypertension and pregnancy—a review of 12 pregnancies in nine women. BJOG: An International Journal of Obstetrics & Gynaecology, 119: 752–761. doi: 10.1111/j.1471-0528.2012.03295.x

Author Information

  1. 1

    Academic Department of Obstetrics and Gynaecology, Faculty of Medicine, Imperial College London, Chelsea and Westminster NHS Foundation Trust

  2. 2

    Adult Congenital Heart Disease Unit, Royal Brompton and Harefield NHS Foundation Trust, and the National Heart and Lung Institute at Imperial College, London

  3. 3

    Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea & Westminster NHS Foundation Trust, London, UK

*Dr RA Curry, Academic Department of Obstetrics and Gynaecology, Faculty of Medicine, Imperial College London, Chelsea & Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK. Email r.curry@imperial.ac.uk

Publication History

  1. Issue published online: 10 APR 2012
  2. Article first published online: 6 MAR 2012
  3. Accepted 19 January 2012. Published Online 6 March 2012.

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Keywords:

  • Pregnancy;
  • pulmonary hypertension

Please cite this paper as: Curry R, Fletcher C, Gelson E, Gatzoulis M, Woolnough M, Richards N, Swan L, Steer P, Johnson M. Pulmonary hypertension and pregnancy—a review of 12 pregnancies in nine women. BJOG 2012;119:752–761.

Objective  To report outcomes in a recent series of pregnancies in women with pulmonary hypertension (PH).

Design  Retrospective case note review.

Setting  Tertiary referral unit (Chelsea and Westminster and Royal Brompton Hospitals).

Sample  Twelve pregnancies in nine women with PH between 1995 and 2010.

Methods  Multidisciplinary review of case records.

Main outcome measures  Maternal and neonatal mortality and morbidity.

Results  There were two maternal deaths (1995 and 1998), one related to pre-eclampsia and one to arrhythmia. Maternal morbidity included postpartum haemorrhage (five cases), and one post-caesarean evacuation of a wound haematoma. There were no perinatal deaths, nine live births and three first-trimester miscarriages. Mean birthweight was 2197 g, mean gestational age was 34 weeks (range 26–39), and mean birthweight centile was 36 (range 5–60). Five babies required admission to the neonatal intensive care unit, but were all eventually discharged home. All women were delivered by caesarean section (seven elective and two emergency deliveries), under general anaesthetic except for one emergency and one elective caesarean performed under regional block.

Conclusions  Maternal and fetal outcomes for women with PH may be improving. However, the risk of maternal mortality remains significant, so that early and effective counselling about contraceptive options and pregnancy risks should continue to play a major role in the management of such women when they reach reproductive maturity.

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