Outcomes of Pregnant Women with Pulmonary Hypertension:Report of 31 Cases

Objective To explore the pregnancy outcomes of women with pulmonary hypertension.Methods A total of 31 cases of pregnancy with pulmonary hypertension treated at our facility fromJanuary 2007 to August 2010 were retrospectively reviewed and divided into three groups according to the systolic pressure of the pulmonarty artery: mild(30～49 mm Hg),moderate(50～79 mm Hg)and severe(≥80 mm Hg).The types of heart diseases,cardiac functional classification(New York heart association,NYHA),time point and form of pregnancy termination and outcomes of the infants and the mothers were analyzed.Results(1)Cardiac functional classification among different degrees of pulmonary hypertension showed significant differences(P0.01).(2) The outcomes of the 31 cases were:term delivery in 9 cases(29.0%),preterm labor in 10 cases(32.3%),iatrogenic abortion in 12 cases(38.7%) and neoborn death in 1 case.(3)Twenty-seven(87.1%) out of the 31 patients underwent caesarean section.(4) Six out of those patients with moderate-to-severe pulmonary hypertension died(a mortality rate of 19.4%).Conclusion(1) Patients with severe pulmonary hypertension are unsuitable for pregnancy while patients with with mild-to-moderate pulmonary hypertension should consult a specialist before pregnancy.(2) The rates of iatrogenic preterm labor and iatrogenic abortion are higher among women with pulmonary hypertension.(3) Caesarean section is a relatively safe way for pregnancy termination in patients with pulmonary hypertension.