Document Detail

Management of pregnancy in women with pulmonary hypertension secondary to SLE and anti-phospholipid syndrome.
MedLine Citation:
PMID:  12139379     Owner:  NLM     Status:  MEDLINE    
Pulmonary hypertension is found in about 10% of patients with systemic lupus erythematosis (SLE). Pulmonary hypertension may be present at the time of diagnosis or may develop after the diagnosis of SLE or anti-phospholipid syndrome (APS). It often presents in the reproductive years and has a significant impact on pregnancy outcome, being a significant cause of indirect maternal deaths. In our observational case series of three patients there were two deaths (66%). In cases 1 and 2 the pulmonary hypertension developed during pregnancy and deteriorated rapidly with markedly abnormal mean pulmonary artery pressures of 80 and 70 mmHg respectively prior to death. Both patients died within 48 hours of delivery. In case 3 the pulmonary hypertension was milder and was diagnosed very early in pregnancy. The patient received multidisciplinary care from the first trimester and the management of the pregnancy, delivery and the early puerperium was planned. Careful epidural anaesthesia was used and the patient had invasive monitoring on the intensive therapy unit (ITU) for 72 hours. Women with pulmonary hypertension need to be aware of the high risk of maternal mortality associated with pregnancy but we believe that an improvement in outcome can be achieved by careful assessment and the use of a multidisciplinary approach from early in pregnancy.
E McMillan; W L Martin; J Waugh; I Rushton; M Lewis; T Clutton-Brock; J N Townend; M D Kilby; C Gordon
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Lupus     Volume:  11     ISSN:  0961-2033     ISO Abbreviation:  Lupus     Publication Date:  2002  
Date Detail:
Created Date:  2002-07-25     Completed Date:  2002-08-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9204265     Medline TA:  Lupus     Country:  England    
Other Details:
Languages:  eng     Pagination:  392-8     Citation Subset:  IM    
Department of Fetal Medicine, Birmingham Women's Hospital, UK.
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MeSH Terms
Antiphospholipid Syndrome / complications*,  therapy*
Fatal Outcome
Hypertension, Pulmonary / complications*,  etiology,  therapy*
Infant, Newborn
Lupus Erythematosus, Systemic / complications*,  therapy*
Pregnancy Complications / therapy*

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