Taiwanese journal of obstetrics & gynecology · 2018
Maternal and fetal outcomes in pregnancies with pulmonary hypertension: Experience of a tertiary center.
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Dolgun Zehra Nihal, Inan Cihan, Sayin N Cenk
Аннотация
OBJECTIVE: Pregnancies complicated with PHT are serious debates for obstetricians due to high maternal and fetal complication potentials. The aim of the study was to present our maternofetal outcomes in pregnant women with pulmonary hypertension.
MATERIALS AND METHODS: This study was performed using data extracted from the medical files of 23 pregnancies of 18 patients with PHT who were followed-up in the obstetrics and gynecology department.
RESULTS: The average age was 27.09 ± 6.97 (range: 14-38) years. The most frequent maternal cardiac pathologies were cardiac valvular disease (mitral or aortic insufficiency) (n = 4), atrial septal defect (n = 3), mitral stenosis (n = 3), ventricular septal defect (n = 2) and arrhythmia (n = 2). Caesarean section and normal vaginal delivery were performed in 13 and 7 deliveries, respectively. Therapeutic dilatation and curettage was performed in 3 patients. Preterm delivery occurred in 4 pregnancies and there were 2 intrauterine growth retardations, 1 preeclampsia and 2 maternal pulmonary edemas. One patient underwent re-laparotomy 5 days after delivery due to uterine hematoma. Totally, 20 newborns (14 female, 6 male) were delivered. Most of the complications were seen in advanced PHT classes.
CONCLUSION: The care of the pregnant women with PHT necessitates a well-planned, multidisciplinary approach focusing on close monitoring before, during and after delivery. This approach may contribute to reduction of poor maternal and fetal outcomes.
MATERIALS AND METHODS: This study was performed using data extracted from the medical files of 23 pregnancies of 18 patients with PHT who were followed-up in the obstetrics and gynecology department.
RESULTS: The average age was 27.09 ± 6.97 (range: 14-38) years. The most frequent maternal cardiac pathologies were cardiac valvular disease (mitral or aortic insufficiency) (n = 4), atrial septal defect (n = 3), mitral stenosis (n = 3), ventricular septal defect (n = 2) and arrhythmia (n = 2). Caesarean section and normal vaginal delivery were performed in 13 and 7 deliveries, respectively. Therapeutic dilatation and curettage was performed in 3 patients. Preterm delivery occurred in 4 pregnancies and there were 2 intrauterine growth retardations, 1 preeclampsia and 2 maternal pulmonary edemas. One patient underwent re-laparotomy 5 days after delivery due to uterine hematoma. Totally, 20 newborns (14 female, 6 male) were delivered. Most of the complications were seen in advanced PHT classes.
CONCLUSION: The care of the pregnant women with PHT necessitates a well-planned, multidisciplinary approach focusing on close monitoring before, during and after delivery. This approach may contribute to reduction of poor maternal and fetal outcomes.