Pulmonary hypertension and pregnancy—a review of 12 pregnancies in nine women
Article first published online: 6 MAR 2012
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 119, Issue 6, pages 752–761, May 2012
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
- Issue published online: 10 APR 2012
- Article first published online: 6 MAR 2012
- Accepted 19 January 2012. Published Online 6 March 2012.
- 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.