Cini Sudhakara Prasad, Shine Kumar, Sudha Sumathy, Radhamony Kunjukutty, Nitu Puthenveettil, Amitabh Chanchal Sen, Jeya Bawani Sivabalakrishnan, Rama Krishna Kumar
Amrita Institute of Medical Sciences and Amrita Vishwa Vidyapeetham University. Sultan Qaboos University Hospital.
India
Journal of Maternal-Fetal and Neonatal Medicine
J Matern Fetal Neonat Med 2022; 35: 3533-3539
DOI: 10.1080/14767058.2020.1828333
Abstract
Objective: To describe maternal and fetal outcomes and N Terminal pro-brain natriuretic peptide (NT-proBNP) trends in pregnancy with pulmonary arterial hypertension (PAH).
Methods: The medical records of all pregnant women with PAH referred to Pulmonary Hypertension Clinic were retrospectively reviewed and analyzed.
Results: We identified 35 pregnancies in 22 women (mean age 27.9 ± 4.7 years, mean weight 50.6 ± 8.1 kg). The diagnoses were Eisenmenger syndrome (16, 72.7%), postoperative residual PAH (3, 13.6%), idiopathic PAH (2, 9.1%), and one (4.5%) had systemic lupus erythematosus. About 23 babies (65.7%) were born alive, gestational age of 35.1 ± 2.9 weeks, 47.8% at term, with a birth weight of 2.1 ± 0.8 kg. There was an elevation of NT-proBNP in the initial 72 h postdelivery (median 138 pg/ml, IQR 112-561). Those with a persistent rise beyond 72 h (median 686 pg/ml, IQR 370-3691) had prolonged recovery postpartum (median postdelivery hospital stay 18 days, IQR 12-22) reflecting continued right ventricular stress and maladaptation. There was single maternal mortality (4.5%).
Conclusions: Maternal and fetal outcomes of pregnancy associated with PAH are better with strict surveillance and multidisciplinary team effort. Postpartum period remains the most vulnerable time. NT-proBNP trends during this period may be a promising objective monitoring tool in identifying at-risk subsets thus improving outcomes.
Categories
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Procedural Risk and Care for Individuals with Pulmonary Vascular Disease
Age Focus: Adult Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
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