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Semin Respir Crit Care Med 2013; 34(05): 681-688
DOI: 10.1055/s-0033-1355438
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Birth Control and Pregnancy Management in Pulmonary Hypertension

Karen M. Olsson
1   Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
,
Xavier Jais
2   INSERM U999 (Hypertension Artérielle Pulmonaire: Physiopathologie et Innovation Thérapeutique), Centre Chirurgical Marie-Lannelongue, Le PlessisRobinson, France
› Institutsangaben
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Publikationsdatum:
13. September 2013 (online)

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Abstract

Pregnancies in patients with pulmonary arterial hypertension (PAH) are associated with serious complications and mortality rates of more than 50%. Advanced medical therapies for PAH have been developed during the past years resulting in improved hemodynamics, exercise capacity, quality of life, and outcome. However, despite these advances, pregnancy in women with PAH is still associated with excessive maternal mortality. Consequently, all current guidelines strongly discourage pregnancy and recommend an effective method of contraception in women of childbearing age. If this fails, early pregnancy termination is advised. Those patients who choose to continue pregnancy should be treated with targeted PAH therapies including prostacyclin analogues and/or phosphodiesterase type 5 inhibitors. The care of the pregnant women with PAH requires a planned, multidisciplinary approach, preferably in a dedicated pulmonary hypertension referral center, focusing on close monitoring before, during and after delivery.

Keywords

hypertension - pulmonary - pregnancy - right heart failure
 

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