Pulmonary hypertension in pregnancy: experience from 45 cases at a tertiary care center

J Matern Fetal Neonatal Med. 2022 May;35(9):1769-1774. doi: 10.1080/14767058.2020.1770216. Epub 2020 May 24.


Objective: Pulmonary hypertension (PH) is a rare maternal cardiac disorder associated with high maternal and fetal mortality. The objective of our study was to evaluate the maternal and fetal outcomes in pregnant women with PH in a single health center.

Study design: 45 pregnant patients with PH, who had undergone antenatal follow-up and delivery at the department of gynecology and obstetrics at a referral center were retrospectively investigated. Maternal and perinatal outcomes were evaluated and descriptive statistics were reported.

Results: According to the WHO classification; 35 patients (78%) were in Group 1; 9 patients (20%) in Group 2 and one patient (2%) were in Group 3. Thirty-three of the cases (73%) had mild, 8 (18%) moderate and 4 (9%) severe PH. The mean delivery week was 35.5. Twenty-four of the cases (56%) delivered before the 37th week and the remaining 19 cases (44%) in the 37th week or later. Rate of cesarean section delivery was 88%. Only one case of maternal death was reported, who was initially diagnosed with PAH during pregnancy. This patient had severe PH and was in Group 1 according to the WHO classification.

Conclusion: While the mortality rates related to PH were reported to be between 30% and 56% several decades ago, recent studies have reported the mortality rates between 5% and 25%. It is believed that the decline in the maternal mortality depended on the developments in the treatment alternatives and multidisciplinary management. However, PH is still a serious condition which requires a multidisciplinary approach and a well-planned obstetric management.

Keywords: Pulmonary hypertension; WHO classification; mortality; pregnancy; preterm delivery.

MeSH terms

  • Cesarean Section
  • Female
  • Humans
  • Hypertension, Pulmonary* / epidemiology
  • Hypertension, Pulmonary* / therapy
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Retrospective Studies
  • Tertiary Care Centers