Long‐term outcomes of pregnant women with pulmonary hypertension diagnosed by echocardiography: a retrospective cohort study in a single center from China

Abstract

Recent studies suggest that pregnancy may not be absolutely contraindicated in women with moderate pulmonary hypertension. We aimed to evaluate the long-term outcomes of pregnant women with pulmonary hypertension diagnosed by echocardiography in our clinical department. Pregnant women with pulmonary hypertension, diagnosed by a pulmonary systolic arterial pressure > 30 mmHg via echocardiography, who were admitted in our department for termination of pregnancy or delivery between 2004 and 2016 were included in this retrospective cohort study. Demographic characteristics, clinical histories, perinatal outcomes, and follow-up outcomes after discharge were reported. The primary outcome was survival of the pregnant women after discharge. A total of 88 pregnant women with pulmonary hypertension were included in this cohort study. The women were categorized into severe and moderate pulmonary hypertension groups according to their pulmonary systolic arterial pressure at admission. Women with severe pulmonary hypertension were significantly more likely to have deteriorated cardiac function and higher incidence of neonatal complications during the perinatal periods (p < 0.05). During a median follow-up of 26 months, the mortality rate was significantly higher in women with severe pulmonary hypertension (p < 0.05). However, the accumulated survival rate was >90% for women with moderate pulmonary hypertension within the follow-up period. Multivariate Cox regression analyses showed that poor cardiac function before pregnancy, irregular antenatal care, and hyperuricemia were independent mortality risk factors for women with pulmonary hypertension after discharge. In conclusion, the long-term survival of pregnant women with moderate pulmonary hypertension diagnosed by echocardiography was considered acceptable in this cohort. Our findings suggest that pregnancy might not be absolutely contraindicated in women with moderate pulmonary hypertension.

Pregnant outcomes of critically ill pregnant patients with pulmonary hypertension: A multicenter retrospective study

“…In addition, for pregnant women with confirmed or moderate to severe PH, echocardiography might be more suitable for dynamic prediction and follow-up because of its non-invasive and convenient. Consistent with recent research ( 20 ), the level of sPAP measured by echocardiography was closely associated with mortality and morbidity of postpartum adverse events in pregnant PH women in our study. Furthermore, the optimal cut-off value of sPAP for predicting mortality was 70 mm Hg, which yielded sensitivity and specificity of 88.9 and 71.1%, respectively.…”

Elevated tricuspid regurgitation velocity is associated with increased adverse haematologic events during pregnancy in women with sickle cell disease

“…1,2 A tricuspid regurgitation velocity (TRV) of at least 2.5 m/s by transthoracic echocardiogram (TTE) is a marker for underlying PH in patients with SCD, and despite a positive predictive value for catheterization confirmed PH of only 31%, 1 is associated with increased mortality. 3,4 Women with PH as defined by TTE have increased risk for adverse events in pregnancy; 5,6 however, data on pregnancy outcomes in women with both SCD and elevated TRV are sparse. We sought to evaluate the impact of elevated TRV on adverse events during pregnancy.…”

Targeting Myadm to Intervene Pulmonary Hypertension on Rats Before Pregnancy Alleviates the Effect on Their Offspring’s Cardiac-Cerebral Systems

“…Inspiringly, it has been noted that pregnancy outcomes are improved due to multidisciplinary cooperation ( Rezk and Gamal 2016 ). A previous study suggested that pregnancy might not be absolutely contraindicated in women with moderate PH ( Lai et al, 2021 ). However, there is still an absolute risk in pregnancy with PH involving maternal and neonatal complications ( Balieva et al, 2021 ).…”