Pregnancy and pulmonary arterial hypertension-improving surveillance and outcomes with multidisciplinary care and N terminal pro-brain natriuretic peptide trends.

Autor:	Prasad CS; Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham University, Kochi, India., Kumar S; Pulmonary Hypertension Clinic, Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham University, Kochi, India., Sumathy S; Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham University, Kochi, India., Kunjukutty R; Department of Obstetrics and Gynecology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham University, Kochi, India., Puthenveettil N; Department of Anesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham University, Kochi, India., Sen AC; Department of Cardiac Anesthesiology, Sultan Qaboos University Hospital, Al Khoud, Oman., Sivabalakrishnan JB; Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham University, Kochi, India., Kumar RK; Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham University, Kochi, India.
Jazyk:	angličtina
Zdroj:	The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2022 Sep; Vol. 35 (18), pp. 3533-3539. Date of Electronic Publication: 2020 Oct 18.
DOI:	10.1080/14767058.2020.1828333
Abstrakt:	Objective: To describe maternal and fetal outcomes and N Terminal pro-brain natriuretic peptide (NT-proBNP) trends in pregnancy with pulmonary arterial hypertension (PAH). Methods: The medical records of all pregnant women with PAH referred to Pulmonary Hypertension Clinic were retrospectively reviewed and analyzed. Results: We identified 35 pregnancies in 22 women (mean age 27.9 ± 4.7 years, mean weight 50.6 ± 8.1 kg). The diagnoses were Eisenmenger syndrome (16, 72.7%), postoperative residual PAH (3, 13.6%), idiopathic PAH (2, 9.1%), and one (4.5%) had systemic lupus erythematosus. About 23 babies (65.7%) were born alive, gestational age of 35.1 ± 2.9 weeks, 47.8% at term, with a birth weight of 2.1 ± 0.8 kg. There was an elevation of NT-proBNP in the initial 72 h postdelivery (median 138 pg/ml, IQR 112-561). Those with a persistent rise beyond 72 h (median 686 pg/ml, IQR 370-3691) had prolonged recovery postpartum (median postdelivery hospital stay 18 days, IQR 12-22) reflecting continued right ventricular stress and maladaptation. There was single maternal mortality (4.5%). Conclusions: Maternal and fetal outcomes of pregnancy associated with PAH are better with strict surveillance and multidisciplinary team effort. Postpartum period remains the most vulnerable time. NT-proBNP trends during this period may be a promising objective monitoring tool in identifying at-risk subsets thus improving outcomes.
Databáze:	MEDLINE
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