Anesthesia for cesarean section in a patient with isolated unilateral absence of a pulmonary artery

Furuya, Takeshi; Iida, Ryoji; Konishi, Jyumpei; Kato, Jitsu; Suzuki, Takahiro

doi:10.1016/j.bjane.2014.07.002

Cited by 1 publication

(3 citation statements)

References 12 publications

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“…We also included the case that is published in this paper, for a total of 14 studies. 4,[8][9][10][11][12][13][14][15][16][17][18][19]…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

“…We identified 14 studies describing UAPA impacting 22 pregnancies. 4,[8][9][10][11][12][13][14][15][16][17][18][19] The median age at diagnosis in our study was 21 years versus a median age of 14 years reported in studies not restricted to pregnant patients. 3 This may reflect selection, where those with more severe symptoms facilitating earlier diagnosis are less likely to pursue pregnancy.…”

Section: Main Findingsmentioning

confidence: 99%

“…Although UAPA may be asymptomatic, maternal adaptations such as increased cardiac output in pregnancy in conjunction with solitary lung perfusion increases the risk for development of pulmonary arterial hypertension (PAH). 4,5 PAH is a contraindication to pregnancy, and pregnancies complicated by PAH have maternal mortality rates of 16 to 56 percent. There is also the potential for worsening of hemoptysis in the setting of expanded blood volume and other cardiopulmonary physiologic changes in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Unilateral Absent Pulmonary Artery in Pregnancy: A Case Report and Systematic Literature Review

Kucirka,

Desai,

LeVarge

et al. 2023

Am J Perinatol

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Objective Unilateral absence of a pulmonary artery (UAPA) is a rare congenital malformation associated with hemoptysis, pulmonary hypertension, and infection. Little is known about the impact on pregnancy outcomes. We sought to synthesize the existing literature on pregnancy outcomes in patients with maternal UAPA. Study Design We report a case of maternal UAPA and performed a systematic review of the existing literature. Articles in English reporting pregnancy outcomes among women with unilateral absence or hypoplasia of the pulmonary artery were included. Articles were reviewed at the abstract level and, if eligible, at the full-text level by two independent reviewers with disagreements adjudicated by a third reviewer. Data were abstracted by two independent reviewers. Outcomes of interest were mode of delivery, gestational age at delivery, intensive care admission, maternal death, and length of stay. Summary statistics for each outcome are presented. Results We identified 14 studies, including the presented case, reporting outcomes in 22 pregnancies impacted by maternal UAPA. Median age at diagnosis was 21 years. Concurrent cardiac comorbidities were reported in 6/13 (46.2%) with pulmonary hypertension in 5/20 (25%) of cases where this information was reported. We observed high rates of preterm birth (4/12, 33.3%), cesarean delivery (10/15, 66.7%), and operative vaginal delivery (2/5, 40.0%). There was one maternal death occurring in the immediate postpartum period for a mortality rate of 4.5%. Conclusion Our study provides a comprehensive review of existing literature on maternal UAPA. Our findings suggest increased rates of adverse outcomes and underscore the importance of early diagnosis, identification of pulmonary hypertension, and multidisciplinary care. Key Points

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“…We also included the case that is published in this paper, for a total of 14 studies. 4,[8][9][10][11][12][13][14][15][16][17][18][19]…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

Section: Main Findingsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Unilateral Absent Pulmonary Artery in Pregnancy: A Case Report and Systematic Literature Review

Kucirka,

Desai,

LeVarge

et al. 2023

Am J Perinatol

View full text Add to dashboard Cite

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Anesthesia for cesarean section in a patient with isolated unilateral absence of a pulmonary artery

Abstract: Spinal anesthesia combined with epidural analgesia is a useful anesthetic method for a Cesarean section in patients with unilateral absence of a pulmonary artery.

Cited by 1 publication

References 12 publications

Unilateral Absent Pulmonary Artery in Pregnancy: A Case Report and Systematic Literature Review

Unilateral Absent Pulmonary Artery in Pregnancy: A Case Report and Systematic Literature Review

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