Abstract
Introduction: Pulmonary hypertension (PH) during pregnancy poses significant risks, including high maternal and fetal morbidity and mortality. Managing pregnant patients with PH in developing countries, presents unique challenges, underscoring the need for further research and resources in these areas.
Methods: This retrospective study at Cho Ray Hospital in Vietnam collected data from January 2011 to September 2023. It included pregnant women with confirmed PH. Data on clinical and subclinical characteristics and outcomes were analyzed using descriptive and inferential statistics.
Results: The present study involved 41 pregnant women diagnosed with PH, and the average age of the patients was 29.3±5.1 years. The mean gestational age at diagnosis was 25.1±8.5 weeks. Idiopathic pulmonary arterial hypertension (iPAH) affected 68.3% of patients, making it the leading cause, followed by congenital heart disease-associated with pulmonary arterial disease (CHD-PAH) at 26.8% and connective tissue disease associated pulmonary arterial hypertension (CTD-PAH) at 4.9%. Echocardiography revealed a mean pulmonary artery pressure of 81.1±30 mmHg. The study found a high maternal mortality rate of 17.1%. Pregnancy termination was indicated in 70.7% of the patients, resulting in a strikingly high fetal mortality rate of 41.4%.
Conclusion: Our study shows that the most common causes of pulmonary arterial hypertension (PAH) associated with pregnancy are iPAH, CHD-PAH, and CTD-PAH, respectively. Contraception should be recommended for women with PAH. Furthermore, due to the high maternal and fetal mortality rates, patients with PAH during Pregnancy require close and individualized management strategies.