Successful Pregnancy in Chronic Obstructive Pulmonary Hypertension Secondary to Pulmonary and Cardiac Hydatid Cysts: A Case Report.

Abstract

Highlights: Pregnancy is typically contraindicated in women with pulmonary hypertension (PH) due to severe mortality risks.A 31-year-old woman with PH, secondary to previous hydatid cysts, conceived against medical advice while on medical therapy. She successfully delivered via emergency C-section at 37 weeks.Her case highlights those high-risk pregnancies complicated by PH can be successfully managed through prompt, multidisciplinary care at a specialized tertiary center.

Background: Pregnancy in women with pulmonary hypertension (PH) is contraindicated because of high mortality rates associated with physiological changes, particularly in the peripartum and postpartum periods. Termination is recommended early if pregnancy occurs. Consequently, clinical experience with continued pregnancy in patients with PH is scarce.

Case presentation: A 31-year-old woman was diagnosed with multiple bilateral pulmonary and right ventricular hydatid cysts. After surgical and pharmacologic treatments, she developed PH due to pulmonary artery obstruction 8 years later. Because of her condition, she was ineligible for surgery and received medical therapy, including tadalafil, bosentan, and eplerenone. After 3 years, she conceived despite advice to avoid pregnancy. At 37 weeks' gestation, she underwent successful emergency cesarean delivery because of maternal dyspnea and tachycardia.

Conclusion: Prompt treatment and regular follow-up in a tertiary care center using a multidisciplinary approach are crucial for managing pregnant patients with PH.