///2019 Abstract Details
2019 Abstract Details2019-07-13T07:45:15-05:00

Pulmonary Hypertension and Pregnancy: Analysis of A Case Series of Thirteen Cases

Abstract Number: T110-519
Abstract Type: Original Research

Jie Zhou MD, MS, MBA, FASA1 ; Wendong Chen MD2

Pulmonary Hypertension and Pregnancy: Analysis of A Case Series of Thirteen Cases

Background

Pulmonary hypertension (PHTN) in pregnancy has long been regarded as high risk for maternal and neonatal complications. Anesthesia management of parturients with PHTN is often challenging, yet literature has been scarce. Our study aimed to identify whether pregnancy outcomes vary by etiology and severity of pulmonary hypertension.

Methods

A retrospective review of medical records from Partners HealthCare Systems was conducted from 1998 to 2018 to identify pregnant women with PHTN. Demographics, etiology, management, and outcomes of maternal and fetal medical records were collected. According to the 2013 World Health Organization the etiology of pulmonary hypertension all patients were divided into 5 groups. PHTN was defined as a mean pulmonary artery pressure greater than 25 mmHg and mean pulmonary artery pressure value of 25 to 49 mmHg, or greater than 50 mmHg or systolic pulmonary artery pressure 70 mmHg or greater corresponded to the mild, or severe PHTN, respectively. Descriptive statistics were used to analysis outcomes.

Results

Thirteen pregnant women with PHTN were identified, including 6 cases due to left heart disease (Etiology 1), 2 cases due to lung diseases and/or hypoxia (Etiology 2), 3 cases due to autoimmune disease (Etiology 3), 1 case due to chronic thromboembolic (Etiology 4) and 1 case with unclear multifactorial mechanisms (Etiology 5). Multidisciplinary approach was practiced except for 1 case with left heart disease. 7 cesarean deliveries were performed; 9 had vaginal delivery under labor epidural. 2 patients were admitted to surgical intensive care unit for postpartum care. We will present the complete cases series at the SOAP meeting.

Discussion

In this retrospective study, we described maternal and fetal outcomes of 13 pregnant women with PHTN. Peripartum maternal and fetal mortality of these patients is often associated with PHTN etiology classification, the severity of PHTN, other comorbidities. Anesthetic method is determined by a multidisciplinary team approach. The functionality of the team works will eventually determined the course and outcomes.

References

1. Dhaval Kolte, et al. J Am Heart Assoc. 2018;7:e009729

2. Sun et al. Medicine (2018) 97:44

3. Marie-Louise Meng, et al. Obstet Gynecol 2017;129:511–20



SOAP 2019