Vol 82, No 7 (2011)
ARTICLES
Primary pulmonary hypertension in pregnancy – a case report
Adam Owerczuk, Sebastian Dąbrowski, Andrzej Basiński, Krzysztof Preis, Dariusz Zieliński, Tomasz Łopaciński, Ewa Raniszewska
Vol 82, No 7 (2011)
ARTICLES
Abstract
Summary Primary pulmonary arterial hypertension, so called idiopathic pulmonary arterial hypertension (IPAH), is a rare and progressive disease with poor prognosis. Pregnancy in patients with this condition is hazardous and makes the prognosis significantly worse. According to WHO, IPAH is a contraindication to pregnancy because of high risk of maternal death and WHO advises to discuss termination in the event of pregnancy. Below we describe a case of a young woman at 16 weeks pregnancy with severe decompensated primary pulmonary hypertension. The patient was admitted to our department because of increasing dyspnoea and swollen legs occurring from 14th week of pregnancy. In the past the patient had been diagnosed with pulmonary hypertension, which had been defined during differential diagnostics as primary pulmonary hypertension. Echocardiographic examination over the last 4 years revealed stable mean pulmonary artery pressure (PAP) of about 50mmHg. The patient was treated efficiently with sildenafil for the last 2 years, but the therapy was discontinued after finding pregnancy. On admission it was established that pregnancy should be terminated. Other reasons of circulatory decompensation, uch as pulmonary embolism, cardiac tamponade or pulmonary diseases, were excluded.
Abstract
Summary Primary pulmonary arterial hypertension, so called idiopathic pulmonary arterial hypertension (IPAH), is a rare and progressive disease with poor prognosis. Pregnancy in patients with this condition is hazardous and makes the prognosis significantly worse. According to WHO, IPAH is a contraindication to pregnancy because of high risk of maternal death and WHO advises to discuss termination in the event of pregnancy. Below we describe a case of a young woman at 16 weeks pregnancy with severe decompensated primary pulmonary hypertension. The patient was admitted to our department because of increasing dyspnoea and swollen legs occurring from 14th week of pregnancy. In the past the patient had been diagnosed with pulmonary hypertension, which had been defined during differential diagnostics as primary pulmonary hypertension. Echocardiographic examination over the last 4 years revealed stable mean pulmonary artery pressure (PAP) of about 50mmHg. The patient was treated efficiently with sildenafil for the last 2 years, but the therapy was discontinued after finding pregnancy. On admission it was established that pregnancy should be terminated. Other reasons of circulatory decompensation, uch as pulmonary embolism, cardiac tamponade or pulmonary diseases, were excluded.
Keywords
idiopathic pulmonary hypertension, pregnancy, heart failure
Title
Primary pulmonary hypertension in pregnancy – a case report
Journal
Ginekologia Polska
Issue
Vol 82, No 7 (2011)
Page views
619
Article views/downloads
2300
Bibliographic record
Ginekol Pol 2011;82(7).
Keywords
idiopathic pulmonary hypertension
pregnancy
heart failure
Authors
Adam Owerczuk
Sebastian Dąbrowski
Andrzej Basiński
Krzysztof Preis
Dariusz Zieliński
Tomasz Łopaciński
Ewa Raniszewska
About this article