Severe Pulmonary Hypertension during Pregnancy

Bonnin, M.; Mercier, F.J.; Sitbon, Olivier; Roger-Christoph, S.; Jaïs, Xavier; Humbert, Marc; Audibert, François; Frydman, René; Simonneau, Gérald; Benhamou, Dan

doi:10.1097/00000542-200506000-00012

Cited by 248 publications

(50 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several case reports, however, have demonstrated successful outcomes in this setting [1,2,3,4,5,6,7,8,9,10]. To our knowledge, this is the first report demonstrating serial hemodynamic changes in the pulmonary circulation in the pre-, peri-, and postpartum periods, and postpartum bleeding in a PAH patient related to anticoagulation in the peripartum period.…”

Section: Discussionmentioning

confidence: 85%

See 1 more Smart Citation

Serial Hemodynamics and Complications of Pregnancy in Severe Pulmonary Arterial Hypertension

Nahapetian

Oudiz²

2007

Cardiology

View full text Add to dashboard Cite

We report a case of a woman who became pregnant after the diagnosis of moderate to severe pulmonary hypertension and underwent successful full-term pregnancy. Pulmonary hemodynamics were monitored before pregnancy and in the peripartum period. The patient was followed closely by the cardiology and high-risk obstetric specialists in the outpatient setting until she underwent c-section with epidural anesthesia. Outpatient medical management included twice daily subcutaneous enoxaparin and once daily amlodipine. Immediately prior to cesarian section, and for several days postoperatively, invasive hemodynamic monitoring was employed to titrate medical therapy. During delivery, strict attention focused on limiting intravenous fluids in order to avoid right ventricular volume overload. The postoperative course was complicated by a spontaneous, acute rise in pulmonary vascular resistance, which was managed with intravenous epoprostenol. In addition, abdominal bleeding, likely related to postoperative anticoagulation and platelet dysfunction, was controlled with transfusion and spontaneously resolved after discontinuing the anticoagulation. This case presents a favorable outcome in a pregnant patient undergoing cesarian section despite several complications related to pulmonary hypertension and right ventricular dysfunction, which are often fatal.

show abstract

Section: Discussionmentioning

confidence: 85%

“…PH in the setting of pregnancy is often fatal [4], with most deaths occurring in the postpartum period [10]. Several case reports, however, have demonstrated successful outcomes in this setting [1,2,3,4,5,6,7,8,9,10].…”

Section: Discussionmentioning

confidence: 99%

Serial Hemodynamics and Complications of Pregnancy in Severe Pulmonary Arterial Hypertension

Nahapetian

Oudiz²

2007

Cardiology

View full text Add to dashboard Cite

show abstract

“…[13132] However, the guidelines on perioperative cardiovascular evaluation for noncardiac surgery from the American College of Cardiology and American Heart Association (2007) do not include PH in the risk stratification of these patients. These guidelines emphasize that most experts agree that PH poses an increased risk for noncardiac surgery; however, no major study has been performed to prove this concept.…”

Section: Pulmonary Hypertension In Noncardiac Surgerymentioning

confidence: 99%

“…[3049] Mortality depends on the etiology of PH, time to recognition, and medical treatment received during pregnancy, delivery, and postpartum. [324950] Patients with Eisenmenger's syndrome have higher maternal mortality (40-52%) than other groups, although most of the evidence comes from studies performed before the introduction of PH-specific therapies. [5152] A late diagnosis and delayed hospitalization are strong predictors of maternal mortality.…”

Section: Pulmonary Hypertension In Pregnancymentioning

confidence: 99%

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Perioperative management in patients with pulmonary hypertension

Tonelli

Minai

2014

Ann Thorac Med

View full text Add to dashboard Cite

Patients with pulmonary hypertension (PH) are being encountered more commonly in the perioperative period and this trend is likely to increase as improvements in the recognition, management, and treatment of the disease continue to occur. Management of these patients is challenging due to their tenuous hemodynamic status. Recent advances in the understanding of the patho-physiology, risk factors, monitoring, and treatment of the disease provide an opportunity to reduce the morbidity and mortality associated with PH in the peri-operative period. Management of these patients requires a multi-disciplinary approach and meticulous care that is best provided in centers with vast experience in PH.In this review, we provide a detailed discussion about oerioperative strategies in PH patients, and give evidence-based recommendations, when applicable.

show abstract

“…Recent evidence has suggested that PH is a risk factor for worse outcomes in both cardiac and noncardiac surgeries. [171819] This risk is believed to be increased with the severity of modified NYHA functional classes and disease severity. The type of anesthesia is left to the experience of the anesthetist, as no conclusive evidence is available to prefer one method of anesthesia over the others.…”

Section: General Measuresmentioning

confidence: 99%

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: General management for pulmonary hypertension

Idrees¹,

Swiston²,

Levy³

2014

Ann Thorac Med

View full text Add to dashboard Cite

Treatment of pulmonary hypertension (PH) patients is challenging and should only be initiated after a comprehensive diagnostic evaluation. Such treatment should ideally be done in specialized centers with full capability for hemodynamic measurements, having access to a broad range of PAH therapies, and adequate experience in the management of critically ill patients.The following discussion is intended to review the general measures and the non-specific (supportive) therapy used in managing PH patients, while the specific therapy will be discussed in a subsequent different article.

show abstract

Severe Pulmonary Hypertension during Pregnancy

Cited by 248 publications

References 32 publications

Serial Hemodynamics and Complications of Pregnancy in Severe Pulmonary Arterial Hypertension

Serial Hemodynamics and Complications of Pregnancy in Severe Pulmonary Arterial Hypertension

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Perioperative management in patients with pulmonary hypertension

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: General management for pulmonary hypertension

Contact Info

Product

Resources

About