Outcome of 30 Pregnant Women with Pulmonary Hypertension at Bangladesh Medical University, Dhaka, Bangladesh.

Abstract

In the recent years, pregnancy outcomes in the patient with pulmonary hypertension (PH) improved with the development of health monitoring system and applications of pulmonary vascular-targeted drugs. But the maternal mortality is still high. So, the purpose of this study was to describe the maternal and foetal outcomes in pregnant women with PH. The clinical data of 30 pregnant women with PH who were admitted to the department of cardiology, Bangladesh Medical University, Dhaka, Bangladesh from January 2020 to December 2022 were collected and descriptively analyzed. Among the 30 pregnant women with pulmonary hypertension, 5(16.6%) had idiopathic pulmonary hypertension (iPAH), 17(56.6%) had pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH), 2(6.66%) had PH related to left heart disease (LHD-PH) and 6(20.0%) had PAH due to other diseases (oPAH). The mean systolic pulmonary artery pressure was <30 mmHg in 8(26.6%) patients, 30-40 mmHg was in 8(26.6%) patients and >40 mmHg in 15(50.0%) patients. Four (13.33%) patients were died within 7 days after delivery and CHD-PAH patients had the highest mortality rate (3/17, 17.64%). Three patients (10.0%) were admitted to the intensive care unit (ICU) and the incidence of heart failure during pregnancy was 20.0%. A total of 63.33% of the patients underwent caesarean section; 63.33% had premature infants; 40.0% had low-birth-weight (LBW) infants; 13.33% had very-low-birth-weight (VLBW) infants; 6.66% had extremely-low-birth-weight (ELBW) infants; 56.66% had small for gestational age (SGA) infants and 3.0% experienced neonatal mortality. Though there was difference in the maternal and foetal outcomes I iPAH, CHD-PAH, LHD-PH and oPAH, it was not statistically significant. Maternal mortality was highest in the CHD-PAH. Therefore, CHD-PAH patients should be advised to avoid pregnancy. Standardized and multidiscipline-assisted maternal management is the key to improve maternal and foetal outcome.