Pulmonary Arterial Hypertension and Pregnancy

Abstract

Pulmonary hypertension in pregnancy has always scared the treating physician and gynecologist due to reported high mortality since ages. The upcoming therapies targeting pulmonary hypertension (calcium channel blockers, nitric oxide, endothelin receptor antagonist, phosphodiesterase type 5 inhibitors) and improvement in hemodynamic monitoring and intensive management in pulmonary arterial hypertension (PAH) specialist centers give a ray of hope to these patients. Termination of pregnancy continues to be a management modality in pregnant patients with PAH. Multidisciplinary approach targeting PAH- and pregnancy-specific therapy in this subset can prove rewarding. Larger multicentric studies in the present era of new pharmacologic agents targeting PAH are required.

Manajemen Anestesi pada Pasien Obstetri dengan Kelainan Jantung Kongenital dan Risiko Hipertensi Pulmonal

“…Hal ini memberikan 500 ml darah dari intervilli ke sirkulasi sentral (autotransfusi). 7,10 Perubahan kardiovaskular tetap terjadi hingga beberapa minggu setelah melahirkan. Curah jantung akan turun setelah 24 jam postpartum dan menjadi normal setelah 12-24 minggu postpartum.…”

Cardio-obstetrics in India: The Mission, the Scope and the Road Ahead

“…These clinics would cater to the needs of preconceptional risk assessment and counseling in patients with cardiac ailments, cardiovascular evaluation and diagnosis during pregnancy, diagnosis and treatment of pregnancy-associated hypertension and preeclampsia, management of native and prosthetic valvular disease, congenital heart disease (naive as well post procedural), cardiomyopathies (peripartum, dilated, and hypertrophic cardiomyopathy), and arrhythmias in pregnancy. [4][5][6][7][8][9][10][11] It would also review methods for fertility control for the patient with cardiac disease and the risk of cardiac drugs during pregnancy and lactation. Moreover, the diagnosis and management of acute catastrophies as deep vein thrombosis and pulmonary embolism during pregnancy, acute myocardial infarction, and spontaneous coronary dissection during pregnancy could have an active involvement of cardio-obstetrics team.…”