Pregnancy in pulmonary arterial hypertension: Midterm outcomes of mothers and offspring

Current guidelines recommend that patients with pulmonary arterial hypertension (PAH) avoid pregnancy because of a high mortality risk for the patients and their offspring. Still, some PAH patients become pregnant. We herein report the mid-term maternal and offspring outcomes of 25 consecutive pregnancies in 16 patients with PAH. Five patients had a total of 8 abortions (5 spontaneous, 3 induced; one of these patients developed right ventricular failure and underwent urgent lung transplantation). Thirteen patients delivered a total of 18 healthy children. One of these patients developed right heart failure in the postpartum period, requiring urgent lung transplantation. All other patients did well and were alive after a follow-up period of 1-12 (median, 6) years. Their infants were also doing well, and all had normal results on a standardized infant developmental questionnaire. These data suggest that nowadays, pregnancy can be associated with good outcomes in selected patients with PAH.