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Women with pulmonary hypertension have a high risk of morbidity and mortality during pregnancy. The inability to increase cardiac output leads to heart failure while further risks are introduced with hypercoagulability and decrease in systemic vascular resistance. There is no proof that new advanced therapies for pulmonary hypertension decrease the risk, though some promising results have been reported. However, pregnancy should still be regarded as contraindicated in women with pulmonary hypertension. When pregnancy occurs and termination is declined, pregnancy and delivery should be managed by multidisciplinary services with experience in the management of both pulmonary hypertension and high-risk pregnancies.
Regitz-Zagrosek V, Blomstrom Lundqvist C, Borghi C, et al. ESC guidelines on the management of cardiovascular diseases during pregnancy of the European Society of Cardiology. Eur Heart J. 2011;Aug 26. doi: 10.1093/eurheartj/ehr218.
Pieper PG. Pre-pregnancy risk assessment and counseling of the cardiac patient. Neth Heart J 2011;19:477–481.
Pieper PG. The pregnant woman with heart disease: management of pregnancy and delivery. Neth Heart J. 2011;xxxxxxxxx.
- Pregnancy in women with pulmonary hypertension
P. G. Pieper
E. S. Hoendermis
- Bohn Stafleu van Loghum