Management of Eisenmenger syndrome in pregnancy with sildenafil and L-arginine

Obstet Gynecol. 2004 May;103(5 Pt 2):1118-20. doi: 10.1097/01.AOG.0000125148.82698.65.


Background: Eisenmenger syndrome in pregnancy may be a life-threatening disease despite recent additions to the treatment options.

Case: We present a woman with severe pulmonary hypertension due to Eisenmenger syndrome treated during pregnancy and delivery and postpartum with L-arginine and sildenafil to enhance the nitric oxide pathway. This combination was associated with significant improvement in the mother's clinical and hemodynamic condition and fetal well-being.

Conclusion: The concomitant use of sildenafil and L-arginine for the management of pulmonary hypertension in pregnancy, combined with multidisciplinary care, permitted a good outcome for the mother and her infant.

Publication types

  • Case Reports

MeSH terms

  • 3',5'-Cyclic-GMP Phosphodiesterases / antagonists & inhibitors*
  • Adult
  • Arginine / therapeutic use*
  • Drug Therapy, Combination
  • Eisenmenger Complex / drug therapy*
  • Female
  • Humans
  • Hypertension, Pulmonary / drug therapy*
  • Hypertension, Pulmonary / etiology
  • Patient Care Team
  • Phosphodiesterase Inhibitors / therapeutic use*
  • Piperazines / therapeutic use*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy*
  • Pregnancy Outcome
  • Purines
  • Sildenafil Citrate
  • Sulfones


  • Phosphodiesterase Inhibitors
  • Piperazines
  • Purines
  • Sulfones
  • Arginine
  • Sildenafil Citrate
  • 3',5'-Cyclic-GMP Phosphodiesterases