Pulmonary Arterial Hypertension in Pregnancy

Ballard, Wenners; Dixon, Brittany; McEvoy, Colleen; Verma, Amanda

doi:10.1016/j.ccl.2020.09.007

Cited by 31 publications

(13 citation statements)

References 59 publications

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“…Nifedipine can inhibit Ca 2+ inflow, relax vascular smooth muscle, dilate coronary artery, and increase coronary blood flow, thus lowering blood pressure. Low-dose coronary artery dilatation 5 Computational and Mathematical Methods in Medicine does not affect blood pressure, so it is a better antianginal drug [30]. In the treatment of PIH, magnesium sulfate is first of all recommended, which can inhibit the activity of central nervous system and conduct a reduction in the release of acetylcholine from motor nerve-muscle junctions and a relaxation of muscle contractions.…”

Section: Discussionmentioning

confidence: 99%

Effects of Nifedipine and Labetalol Combined with Magnesium Sulfate on Blood Pressure Control, Blood Coagulation Function, and Maternal and Infant Outcome in Patients with Pregnancy-Induced Hypertension

Yu-ping

Zhang

2022

Computational and Mathematical Methods in Medicine

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Objective. The purpose is to investigate the influence of nifedipine, labetalol, and magnesium sulfate on blood pressure control, blood coagulation, and maternal and infant outcome in those suffering from pregnancy-induced hypertension (PIH). Methods. From January 2019 to April 2021, 100 participants with PIH in our center were randomly assigned to a control group and a research group. As a control, nifedipine combined with magnesium sulfate was administered. Nifedipine, labetalol, and magnesium sulfate were administered to the research group. The curative effect, blood pressure level, blood coagulation function, vascular endothelial function, and pregnancy comparisons were made between the two groups. Results. Based on the results of the study, the effective rate totaled 92.00%, while as for the control group, it was 80.0%, which indicates that there was a statistically significant difference between the effective rates of the research group and that of the control group, and the difference was statistically significant ( P < 0.05 ). Blood pressure and blood coagulation function did not differ significantly between the two groups before treatment, and the difference was not statistically significant ( P > 0.05 ). After treatment, both groups experienced a significant drop in systolic and diastolic blood pressure. After treatment, a higher PT index was found in the research group than in the control group. Likewise, the Fbg, D-D, and PLT were lower compared to those in the control group, and the difference was statistically significant ( P < 0.05 ). Neither group had significantly different vascular endothelial function before treatment, and the difference was not statistically significant ( P > 0.05 ). After treatment, the ET-1 of the two groups decreased, and the level of NO increased. There was a lower ET-1 in the research group than in the control group as well as a higher NO level in the research group than in the control group, and the difference was statistically significant ( P < 0.05 ). Compared with the pregnancy outcome, in comparison to the controls, the research group had a higher vaginal delivery rate. Significantly, fewer cases of fetal distress, intrauterine asphyxia, and placental abruption were reported in the research group than in the control group, and the difference was statistically significant ( P < 0.05 ). Conclusion. Nifedipine, in combination with magnesium sulfate and labetalol, is effective at treating PIH, reducing blood pressure, improving blood coagulation, preventing cardiovascular events and vascular endothelial function, and further improve the pregnancy outcome.

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Section: Discussionmentioning

confidence: 99%

Effects of Nifedipine and Labetalol Combined with Magnesium Sulfate on Blood Pressure Control, Blood Coagulation Function, and Maternal and Infant Outcome in Patients with Pregnancy-Induced Hypertension

Yu-ping

Zhang

2022

Computational and Mathematical Methods in Medicine

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“…Due to the high pulmonary vascular resistance, patients with pulmonary hypertension cannot tolerate these changes, resulting in excessive right ventricular afterload. This eventually induces adverse cardiac events such as deterioration of cardiac function, pulmonary hypertension crisis, and heart failure [44,45]. This meta-analysis showed that the incidence of cardiac complications in the moderate-to-severe group was three times that in the mild group.…”

Section: Discussionmentioning

confidence: 78%

Pregnancy feasibility in women with mild pulmonary arterial hypertension: A systematic review and meta-analysis

Gao

Cui

et al. 2022

Preprint

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Background The aim of this study was to evaluate the pregnancy feasibility of women with mild pulmonary hypertension according to pregnancy outcomes. Methods This systematic review and meta-analysis compared the differences in maternal and fetal outcomes between mild and moderate-to-severe pulmonary hypertension. Relevant English and Chinese literature were searched in the PubMed, Embase, Cochrane Central Register of Controlled Trials (COCHRANE), CNKI, WanFang Data, and VIP databases between January 1, 1990 and October 1, 2021, and the references of the included articles and relevant systematic reviews were reviewed to determine whether studies were missed. The inclusion criteria were randomized controlled and observational studies (including case-control studies and cohort studies) examining maternal and fetal pregnancy outcomes with pulmonary hypertension. Conference abstracts, case reports, case series reports, non-comparative studies, and review articles were excluded. Results This meta-analysis included 29 studies. In this study, maternal and fetal outcomes were better in the mild pulmonary hypertension group than in the moderate-to-severe group. Regarding maternal mortality, the mild group was much lower than the moderate-to-severe group. We found a significant decrease in maternal mortality in the mild group after 2010. However, no significant difference in maternal mortality before and after 2010 was observed in the moderate to severe group. Cardiac complications, ICU admission, neonatal preterm birth, small for gestational age infants, low birth weight infants, neonatal asphyxia, and neonatal mortality were significantly lower in the mild pulmonary hypertension group than in the moderate-to-severe pulmonary hypertension group. The cesarean section rates of the two groups were similar. However, the vaginal delivery rate in the mild pulmonary hypertension group was significantly higher than that in the moderate-to-severe pulmonary hypertension group. Conclusions This meta-analysis confirmed that pregnancies with mild pulmonary hypertension had significantly better maternal and fetal outcomes than those with moderate to severe pulmonary hypertension. For patients with mild pulmonary hypertension and good cardiac function, continued pregnancy or even delivery should be considered under multidisciplinary monitoring. However, maternal and fetal complications with moderate to severe pulmonary hypertension significantly increase. Hence, it is essential to evaluate pregnancy risk and terminate it in time.

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“…Pulmonary alveolar proteinosis can appear for the first time in pregnancy and can easily be mistaken for other more prevalent pulmonary diseases such as asthma, pulmonary hypertension, or pulmonary embolism, and more recently, COVID-19 [ 32 , 33 , 34 , 35 ]. Due to the limited possibility of the use of all diagnostic techniques during pregnancy, the correct diagnostic could be delayed.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Alveolar Proteinosis and Pregnancy: A Review of the Literature and Case Presentation

et al. 2022

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Pulmonary Alveolar Proteinosis (PAP) is a rare, usually autoimmune, disease, where surfactant accumulates within alveoli due to decreased clearance, causing dyspnea and hypoxemia. The disease is even more rare in pregnancy; nevertheless, it has been reported in pregnant women and can even appear for the first time during pregnancy as an asthma-like illness. Therefore, awareness is important. Similarly to many autoimmune diseases, it can worsen during pregnancy and postpartum, causing maternal and fetal/neonatal complications. This paper offers a narrative literature review of PAP and pregnancy, while illustrating a case of a pregnant patient with known PAP who developed preeclampsia in the third trimester but had an overall fortunate maternal and neonatal outcome.

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Pulmonary Arterial Hypertension in Pregnancy

Cited by 31 publications

References 59 publications

Effects of Nifedipine and Labetalol Combined with Magnesium Sulfate on Blood Pressure Control, Blood Coagulation Function, and Maternal and Infant Outcome in Patients with Pregnancy-Induced Hypertension

Effects of Nifedipine and Labetalol Combined with Magnesium Sulfate on Blood Pressure Control, Blood Coagulation Function, and Maternal and Infant Outcome in Patients with Pregnancy-Induced Hypertension

Pregnancy feasibility in women with mild pulmonary arterial hypertension: A systematic review and meta-analysis

Pulmonary Alveolar Proteinosis and Pregnancy: A Review of the Literature and Case Presentation

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