ABSTRACT
Background: Pulmonary hypertension (PH) during pregnancy poses significant risks to both
maternal and fetal health. Understanding the complex interplay of risk factors, management strategies, and long-term implications is crucial for optimizing outcomes in such high-risk pregnancies. This study aims to comprehensively analyze the maternal and fetal outcomes in pregnancies complicated by pulmonary hypertension.
Aim: The aim of this study is to assess the maternal and fetal outcomes in pregnancies complicated by pulmonary hypertension, elucidating the underlying risk factors, evaluating the efficacy of management strategies, and investigating the long-term implications for both mother and child.
Method: A retrospective cohort study was conducted, involving pregnant women with confirmed pulmonary hypertension who received care at a tertiary referral center between Feburary 2023 and Feburary 2024. Electronic medical records were reviewed to collect demographic data, medical history, details of pulmonary hypertension diagnosis and management during pregnancy, maternal outcomes, and fetal outcomes. Statistical analysis was performed to identify significant risk factors associated with adverse outcomes and to evaluate the impact of different management strategies.
Results: A total of 90 pregnant women with pulmonary hypertension were included in the study. The mean age was 19 years, and the majority of patients had WHO functional class II or III pulmonary hypertension. The most common etiologies of pulmonary hypertension were idiopathic and associated with connective tissue diseases. Maternal outcomes were marked by a high rate of maternal complications, including exacerbation of pulmonary hypertension, heart failure, and preeclampsia. Fetal outcomes revealed a significant incidence of preterm birth, intrauterine growth restriction, and neonatal complications. Multivariate analysis identified maternal functional class, oxygen therapy requirement, and use of pulmonary vasodilators during pregnancy as significant predictors of adverse outcomes.
Conclusion: Pregnancies complicated by pulmonary hypertension are associated with considerable maternal and fetal morbidity and mortality. Optimal management requires a multidisciplinary approach involving cardiologists, obstetricians, and neonatologists. Early identification of high-risk patients, close monitoring throughout pregnancy, and tailored management strategies are essential for improving outcomes. Long-term follow-up is necessary to assess the impact of pulmonary hypertension on maternal health and the development of the offspring.
Keywords: Pulmonary hypertension, pregnancy, maternal outcomes, fetal outcomes, risk factors, management strategies, long-term implications.