Successful Management of Pregnancy in a Patient with Systemic Lupus Erythematosus-associated Pulmonary Arterial Hypertension

Intern Med. 2018 Jun 1;57(11):1655-1659. doi: 10.2169/internalmedicine.0033-17. Epub 2018 Jan 11.

Abstract

Pregnancy in women with systemic lupus erythematosus (SLE)-associated pulmonary arterial hypertension (PAH) remains a high risk. We successfully managed a pregnancy in a patient with SLE-PAH. A 31-year-old pregnant woman with SLE-PAH had worsening PAH and SLE flare-up during pregnancy and a sudden increase in pulmonary arterial pressure after delivery. SLE-PAH was controlled by continuous intravenous epoprostenol and inhaled nitric oxide therapy combined with high-dose corticosteroids under close hemodynamic monitoring. Women with SLE-PAH should avoid pregnancy. However, in case of a similar event, we recommend our case as a good reference for improving the outcome of pregnancy with SLE-PAH.

Keywords: pregnancy; pulmonary arterial hypertension; systemic lupus erythematosus.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use
  • Epoprostenol / therapeutic use
  • Female
  • Humans
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / diagnosis*
  • Hypertension, Pulmonary / drug therapy
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / diagnosis*
  • Lupus Erythematosus, Systemic / therapy
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / etiology

Substances

  • Antihypertensive Agents
  • Epoprostenol