Wander Gurleen, Montanaro Claudia, Dixit Prithvi, Dob Daryl, Johnson Mark R, Patel Roshni R
Department of Obstetrics, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Department of Metabolism, Digestion and Reproduction, Imperial College London, UK.
Int J Cardiol Congenit Heart Dis. 2025 Jan 7;19:100566. doi: 10.1016/j.ijcchd.2025.100566. eCollection 2025 Mar.
Pulmonary hypertension (PH) is a term used to describe a complex heterogenous group of conditions defined by a mean pulmonary arterial pressure of more than 20 mmHg at rest on right-heart catheterization. PH in pregnancy is associated with high rates of maternal morbidity and mortality and poor fetal outcomes. Currently, pregnancy in these women is classified as modified WHO class IV (pregnancy contraindicated). More recent data suggest that the prognosis varies with the underlying aetiology as well as with PH severity. Consequently, management during pregnancy must be individualised, with patients cared for in a tertiary unit as part of an experienced multidisciplinary team. In this article, we will discuss the importance of preconception counselling, the impact of the haemodynamic changes induced by pregnancy, the maternal and fetal risks of pregnancy in women with PH, and how these can be minimised by close antenatal, intrapartum and post-partum care and the development of individualised pregnancy plans.
肺动脉高压（PH）是一个术语，用于描述一组复杂的异质性病症，这些病症通过右心导管检查确定为静息时平均肺动脉压超过20 mmHg。妊娠合并肺动脉高压与孕产妇高发病率和死亡率以及不良胎儿结局相关。目前，这些女性的妊娠被归类为世界卫生组织修订的IV级（妊娠禁忌）。最新数据表明，预后因潜在病因以及肺动脉高压的严重程度而异。因此，孕期管理必须个体化，患者应在三级医疗单位由经验丰富的多学科团队进行护理。在本文中，我们将讨论孕前咨询的重要性、妊娠引起的血流动力学变化的影响、肺动脉高压女性妊娠的母婴风险，以及如何通过密切的产前、产时和产后护理以及制定个体化妊娠计划将这些风险降至最低。
