Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL.
Division of Maternal-Fetal medicine, The University of Cincinnati, Cincinnati, OH.
Am J Obstet Gynecol MFM. 2020 May;2(2):100087. doi: 10.1016/j.ajogmf.2020.100087. Epub 2020 Jan 23.
Pulmonary hypertension is characterized by elevated pulmonary artery pressure caused by several clinical conditions that affect pulmonary vasculature. Morbidity and death in this condition are related to the development of right ventricular failure. Normal physiologic changes that occur in pregnancy to support the growing fetus can pose hemodynamic challenges to the pregnant patient with pulmonary hypertension that results in increased morbidity and mortality rates. Current guidelines recommend that patients with known pulmonary hypertension be counseled against pregnancy. This review aims to provide clinicians with guidelines for preconception counseling, medication management, and delivery planning.
肺动脉高压的特征是肺动脉压力升高,由多种影响肺血管的临床情况引起。这种情况下的发病率和死亡率与右心衰竭的发展有关。为了支持不断成长的胎儿,妊娠期间会发生一些正常的生理变化,这会对患有肺动脉高压的孕妇造成血流动力学方面的挑战,导致发病率和死亡率增加。目前的指南建议对已知患有肺动脉高压的患者进行避孕指导。本综述旨在为临床医生提供孕前咨询、药物管理和分娩计划方面的指导。