Eisenmenger Syndrome in Pregnancy: A Challenging Case With Important Implications for Primary Care and Maternal Mortality Reduction.

Eisenmenger syndrome (ES) represents the advanced form of pulmonary arterial hypertension (PAH) associated with a reversed or bidirectional shunt at the atrioventricular or aortopulmonary level. Pregnant women have a higher risk of developing volume overload due to this syndrome, compounded by the physiological changes of pregnancy, which can result in rapidly progressive cardiopulmonary decompensation and thrombotic complications. Due to the substantial risk to both the mother and fetus, women are advised not to conceive or to terminate the pregnancy in the first trimester. However, with appropriate management and careful consideration of all potential risks, positive neonatal and maternal outcomes can be achieved. We report a case of an 18-year-old primigravida with PAH and preeclampsia at 35+5 weeks' period of gestation (POG), who presented to our center for the first time with lower limb and vulval swelling.