Objective: To identify the vary of obstetric outcomes by the severity of pulmonary hypertension (PH).
Methods: A retrospective study involved pregnancies with PH in one certain academic institution. Total 78 pregnancies with PH were classified into three groups according the mean pulmonary arterial systolic pressure: mean pulmonary arterial systolic pressure 30-49 mm Hg (mild-PH group), mean pulmonary arterial systolic pressure 50-69 mm Hg (moderate-PH group) and mean pulmonary arterial systolic pressure ≥ 70 mm Hg (severe-PH group). The clinical features and obstetric outcomes were described and compared among three groups.
Results: The incidence of PH was 0.23%, including 57 cases in mild-PH group, 10 cases in moderate-PH group and 11 cases in severe-PH group. Meanwhile, pregnancies with mild PH present NYHA class I/II (P < 0.001). General anesthesia (P < 0.001) and advanced intensive care (P = 0.011) were supplied for pregnancies with severe PH. There was no significant difference in rate of caesarean delivery. Furthermore, severity of PH increased the risk of neonatal death (P = 0.040).
Conclusion: The severity of PH seems to be a poor prognosis of neonatal death. Intensive care should be provided for pregnancies with severe PH.
Keywords: obstetric outcomes; poor prognosis; pulmonary hypertension; severity.
© 2018 Japan Society of Obstetrics and Gynecology.