Impact of Pulmonary Hypertension on Maternal and Fetal Outcomes in Pregnancy

Abstract

Background: Pulmonary hypertension (PH) means pulmonary artery pressure that is more than 25 mmHg at rest or 30 mmHg during physical activity. Obstetricians dispute extensively about PH-complicated pregnancies because of the significant risk of maternal and fetal disorders. Objective: To explore the maternal and fetal outcomes in pregnancies with pulmonary hypertension. Methodology: The current study was conducted at the Department of Gynecology, District Headquarter Hospital, Narowal from February 2020 to December 2020. Women who were pregnant and had either received a new or previous diagnosis of PH underwent follow-up and gave birth at our clinic were included in this study. Parameters pertaining to basic descriptive, medical, cardiac, and obstetrical data, along with maternofetal outcomes and issues, were collected. In close coordination with the pediatric, cardiology, hematology, chest disease, neonatology, critical care unit, and anesthesiology departments, standard protocols were adhered to. The last menstruation date and the results of the first trimester's ultrasound were used to determine the gestational age. The study was conducted after receiving approval from the institute's ethics committee. Results Out of 20 pregnancies, 6 pregnant women have been identified as being in Class I, 4 as being in Class II, 5 as being in Class III, and 5 as being in Class IV of the NYHA functional status classification in PH. The same table also included the clinical categories of the individuals. Pulmonary hypertension had been identified during pregnancy was 2 (10%) while 18 (90%) individuals had already been diagnosed. The most frequent maternal cardiac pathologies were mitral or aortic insufficiency cardiac disease (25%), atrial septal defect (20%), mitral stenosis (15%), ventricular septal defect 10%) and arrhythmia 10%). Conclusion It was concluded from the current study that Patients who are pregnant with PH require a well-thought-out, multidisciplinary approach to care that focuses on close observation before, during, and following delivery.