Pregnancy and pulmonary hypertension

Best Pract Res Clin Obstet Gynaecol. 2014 May;28(4):579-91. doi: 10.1016/j.bpobgyn.2014.03.003. Epub 2014 Mar 14.


Pulmonary hypertension during pregnancy is associated with considerable risks of maternal mortality and morbidity. Our systematic review of the literature on the use of targeted treatments for pulmonary arterial hypertension during pregnancy indicates a considerable decrease of mortality since a previous review in 1998 (16% v 38%), and a further non-significant decrease in mortality since the latest review in 2009 (16% v 25%). In addition to the use of targeted treatments, the timely institution of these treatments, and early planned delivery, may contribute to better outcome. Furthermore, research suggests that women with mild pulmonary hypertension or favourable functional class may have a better prognosis, but there is yet no proof of decreased mortality among these women. Despite an improved prognosis, pregnancy is contra-indicated in women with pulmonary hypertension and, when pregnancy occurs, termination should be considered. When pregnancy continues, management by a multidisciplinary team in a specialist centre is indicated.

Keywords: Eisenmenger syndrome; heart disease; pregnancy; pulmonary hypertension; treatment.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Arterial Pressure
  • Contraception
  • Directive Counseling
  • Female
  • Humans
  • Hypertension, Pulmonary / drug therapy*
  • Hypertension, Pulmonary / mortality*
  • Hypertension, Pulmonary / pathology
  • Hypertension, Pulmonary / physiopathology
  • Maternal Mortality
  • Molecular Targeted Therapy*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy*
  • Pregnancy Complications, Cardiovascular / mortality*
  • Pregnancy Complications, Cardiovascular / pathology
  • Pregnancy Complications, Cardiovascular / physiopathology