دوره 12، شماره 1 - ( 11-1404 )
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Bahrami P, Zamansarai S, Teymori N. Maternal and fetal outcomes in pregnant women with moderate-to-severe pulmonary hypertension: A retrospective cohort study from a tertiary cardio-obstetric center in Iran. Caspian J Reprod Med 2026; 12 (1) :34-42
URL: http://caspjrm.ir/article-1-299-fa.html
URL: http://caspjrm.ir/article-1-299-fa.html
Maternal and fetal outcomes in pregnant women with moderate-to-severe pulmonary hypertension: A retrospective cohort study from a tertiary cardio-obstetric center in Iran. نشریه طب تولید مثل خزر. 1404; 12 (1) :34-42
: (20 مشاهده)
Background: Pulmonary hypertension (PH) during pregnancy is associated with high maternal and fetal morbidity and mortality. Despite guideline-based recommendations discouraging pregnancy in women with PH, real-world data remain limited. This study aimed to evaluate maternal and fetal outcomes among pregnant women with moderate-to-severe PH managed at a tertiary referral center in Iran.
Methods: This retrospective cohort study included 37 pregnant women with an estimated systolic pulmonary artery pressure (sPAP) ≥40 mmHg managed between January 2019 and December 2023. As right heart catheterization was not routinely feasible during pregnancy, PH diagnosis and classification were based on comprehensive clinical assessment, transthoracic echocardiography, and other non-invasive investigations. Maternal characteristics, PH etiology, pregnancy management, and maternal and perinatal outcomes were retrospectively analyzed.
Results: The mean maternal age was 27.8 ± 2.1 years. Most women were classified as World Health Organization functional class II (56.8%) or III (32.4%). Group 1 pulmonary arterial hypertension (40.5%) and Group 2 PH due to left heart disease (37.8%) were the predominant clinical classifications. Therapeutic pregnancy termination and maternal mortality each occurred in four patients (10.8%). Twenty-nine pregnancies (78.4%) resulted in live births, while preterm birth occurred in 13 pregnancies (35.1%). Cesarean delivery accounted for 60.0% of completed deliveries. Women with higher estimated sPAP appeared to experience a greater burden of adverse maternal outcomes.
Conclusion: Pregnancy complicated by moderate-to-severe PH remains associated with considerable maternal and fetal risk despite specialized multidisciplinary care. Early diagnosis, preconception counseling, individualized risk assessment, and management in experienced cardio-obstetric centers are essential to optimize maternal and fetal outcomes. Given the retrospective single-center design, reliance on echocardiographic diagnosis, and limited sample size, these findings should be interpreted cautiously and confirmed in larger prospective multicenter studies.
Methods: This retrospective cohort study included 37 pregnant women with an estimated systolic pulmonary artery pressure (sPAP) ≥40 mmHg managed between January 2019 and December 2023. As right heart catheterization was not routinely feasible during pregnancy, PH diagnosis and classification were based on comprehensive clinical assessment, transthoracic echocardiography, and other non-invasive investigations. Maternal characteristics, PH etiology, pregnancy management, and maternal and perinatal outcomes were retrospectively analyzed.
Results: The mean maternal age was 27.8 ± 2.1 years. Most women were classified as World Health Organization functional class II (56.8%) or III (32.4%). Group 1 pulmonary arterial hypertension (40.5%) and Group 2 PH due to left heart disease (37.8%) were the predominant clinical classifications. Therapeutic pregnancy termination and maternal mortality each occurred in four patients (10.8%). Twenty-nine pregnancies (78.4%) resulted in live births, while preterm birth occurred in 13 pregnancies (35.1%). Cesarean delivery accounted for 60.0% of completed deliveries. Women with higher estimated sPAP appeared to experience a greater burden of adverse maternal outcomes.
Conclusion: Pregnancy complicated by moderate-to-severe PH remains associated with considerable maternal and fetal risk despite specialized multidisciplinary care. Early diagnosis, preconception counseling, individualized risk assessment, and management in experienced cardio-obstetric centers are essential to optimize maternal and fetal outcomes. Given the retrospective single-center design, reliance on echocardiographic diagnosis, and limited sample size, these findings should be interpreted cautiously and confirmed in larger prospective multicenter studies.
نوع مطالعه: گزارش مورد |
موضوع مقاله:
Obstetrics and Gynecology
دریافت: 1405/2/22 | پذیرش: 1405/4/5 | انتشار: 1405/4/7
دریافت: 1405/2/22 | پذیرش: 1405/4/5 | انتشار: 1405/4/7
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