TY  - CHAP
M1  - Book, Section
TI  - Pulmonary Hypertension
A1  - Duarte, Alexander G.
A2  - Pacheco, Luis D.
A2  - Saade, George R.
A2  - Hankins, Gary D.V.
PY  - 2015
T2  - Maternal Medicine
AB  - Cardiac  disease  is  a  frequent  cause  of  morbidity  and  mortality  during  pregnancy.1,2  In  the  past,  mitral  stenosis  because  of  rheumatic  heart  disease  was  the  most  common  cause  of  cardiac  disease  associated  with  pregnancy;  however,  two  registries  indicate  that  congenital  heart  disease  is  the  most  prevalent  form  of  heart  disease  complicating  pregnancy.3,4  Notably,  mitral  stenosis  and  congenital  heart  disease  are  associated  with  the  development  of  pulmonary  vascular  disease.  However,  congenital  heart  disease  associated  with  pulmonary  hypertension  and  idiopathic  pulmonary  arterial  hypertension  (PAH)  are  significant  causes  of  morbidity  and  mortality  in  the  parturient  with  case  series  indicating  a  30%  to  56%  maternal  and  9.5%  fetal  mortality.2,5  PAH  affects  young  women,  and  advances  in  therapies  have  allowed  women  with  PAH  to  survive  to  childbearing  years  thereby  resulting  in  a  greater  number  of  parturients  with  this  disease  process.6  Yet,  consensus  guidelines  recommend  that  women  with  pulmonary  hypertension,  who  are  of  child  bearing  potential,  use  effective  contraception  to  avoid  pregnancy  and  in  the  event  of  pregnancy,  early  termination  is  advised.7  Although  these  recommendations  are  medically  justifiable,  some  patients  become  pregnant  against  medical  advice  or  consider  pregnancy  termination  as  morally  objectionable.8,9,10  Hence,  prenatal  counseling  concerning  contraception  and  management  during  and  after  pregnancy  are  important  issues  in  this  group.  This  chapter  will  focus  on  management  of  PAH  during  and  after  pregnancy  in  the  current  era  of  PAH-specific  therapies.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - obgyn.mhmedical.com/content.aspx?aid=1115519497
ER  -