Clinical analysis of 44 cases in pregnant women with pulmonary hypeternsion complicating cardiac disease

ObjectiveTo evaluate the pregnancy outcome and treatment of women with pulmonary hypertension complicating cardiac disease. MethodsClinical data of 44 cases of pregnant women with pulmonary hypertension from Jan 1998 to Jan 2008 were analyzed and they were divided into three groups: 29 cases of slight group, 8 cases of moderate group and 7 cases of severe group. The types of heart disease, cardiac functional status (New York heart association, NYHA), gestational weeks of pregnancy termination, mode of delivery and outcomes of infants were compared between the groups. Results24 cases of NYHA class Ⅰ～Ⅱ were in slight group and 8 cases of NYHA class Ⅱ～Ⅲ were in moderate group and 7 cases of NYHA class Ⅲ～Ⅳ were in severe group; The rate of moderate and severe pul-monary hypertension was 53% (8/15) in rheumatic heart disease. The rate of slight and moderate pulmonary hypertension was 87% (20/23) in congenital heart disease; The rate of term delivery was 76% (22/29) in slight group. The rate of term delivery was 1/8, preterm labor 2/8, abortion 5/8 in moderate group. The rate of term delivery was 1/7, preterm la-bor occurred in 3 cases, and abortion in 3 cases in severe group; Caesarean section rate was 71% (31/44) among all patients; Overall maternal mortality was 7% (3/44).ConclusionsThe rate of heart failure, Perinatal morbidity and fetal loss gradually increase with the severity of pulmonary hypertension. The severity of pulmonary hypertension in rheumatic heart disease is higher than in congenital heart disease.Termination of pregnancy by surgery is a safe deliverymethod.