Dr Nalini Newbigging1, Dr Christina Julious1, Dr Sudha Jasmine1, Dr Sowmya Sathyendra1, Dr Audrin Lenin1, Dr Kavita Abraham1, Dr Swati Rathore1, Dr Jiji Mathews1
1Christian Medical College And Hospital , Vellore, India
Biography:
Dr. Nalini Sarah Newbigging, completed her MD in Medicine in 2019, from Christian Medical College Vellore, India. She .is currently an Assistant Professor at Christian Medical College, Vellore. Her areas of interest include Obstetric Medicine and training in POCUS. She is actively involved in undergraduate and post graduate education.
Abstract:
Pulmonary hypertension (PH) during pregnancy carries a high risk for maternal and feotal mortality during pregnancy; with the advancement of therapeutic options, the mortality risk has reduced from 30-56% to 9-25%.(1)
Between 2013-2024, 34 pregnant women with a diagnosis of PH were managed in a university teaching hospital in South India. The mean age at pregnancy was 29.68 years; 10 (29.4%) were primigravida. The mean gestational age at the booking visit was 23 weeks. 23 (67.6%) were diagnosed before the pregnancy, and 11 (32.4%) were diagnosed during the current pregnancy.
28 (82.4%) were symptomatic, most frequently with dyspnoea 27 (79.4%). 21 (61.8%) had a palpable second heart sound. 9 (26.5%) and 8(23.5%) were symptomatic during the third the second trimester respectively.
16 (47.1%) were initiated on sildenafil, and 5(14.7%) on calcium channel blockers ,14(41%) required oxygen therapy. 6(17.4) were admitted for 4-12 weeks to ensure maternal safety.
19 (55.9%) of the deliveries were by caesarean section, and 5 (14.7%) were instrumental deliveries 1 had normal delivery 5 (14.7 %) had medical termination and 2(5.88 %) were referred in morbid condition. 16(47.1%) pregnancies were continued due to presentation at an advanced gestational age, and 11 (32.4%) at the patient's request despite counselling.
16(47.1%) deliveries were preterm, and 9(26.5%) were term with a mean birth weight of 2.150kg.
21 (61.8%) were classified as Group 1 PH, 12(35.3%) as Group 2 and 1(2.9%) as group 3.
2 mothers died in the perinatal period and one 18 months after delivery, maternal mortality of < 10%.
Close monitoring with prolonged hospitalisations may improve survival in PH during pregnancy.
Keywords
Pulmonary Hypertension, Pregnancy Outcomes
References
Afify H, Kong A, Bernal J, Elgendy IY. Pulmonary Hypertension in Pregnancy: Challenges and Solutions. Integr Blood Press Control.
2022 Apr 2;15:33–41.