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Pulmonary Hypertension and Pregnancy: Management and Outcome

Pulmonary Arterial Hypertension (PAH) is a disorder defined by measuring mean pulmonary arterial pressure above 25 mmHg on Right Heart Catheterization (RHC). This disorder is characterized by rapid right heart failure and death if not adequately treated. According to the latest classification there are about 40 different diseases which can result in pulmonary hypertension. PAH can be idiopathic or can be associated with a variety of medical conditions such as scleroderma, congenital heart disease, left heart failure, lung disease or chronic pulmonary thromboembolism. The average age at diagnosis is 37 years and female to male ratio is about 1.7:1, therefore, the disease is frequently encountered in younger females. Female patients with PAH may become pregnant and occasionally the first clinical manifestations of PAH are seen during the course of pregnancy. It is well known that pregnancy poses an immense risk to females with PAH and maternal mortality reached 56% in early reports published between 1978 and 1996 and even in recent reports mortality rate remains unacceptably high (25-30%). Therefore, current guidelines recommend that pregnancy be avoided or terminated early in women with PAH.

Pulmonary Hypertension and Pregnancy: Management and Outcome

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