POTS and Pregnancy: A Review of Literature and Recommendations for Evaluation and Treatment

Kate Morgan,1 Angela Smith,2 Svetlana Blitshteyn3,4 1School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle, New South Wales, Australia; 2HNE Health Libraries, Hunter New England Local Health District, Newcastle, New South Wales, Australia; 3Department of Neurology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA; 4Dysautonomia Clinic, Williamsville, NY, USACorrespondence: Svetlana Blitshteyn, 300 International Drive, Suite 100, Williamsville, NY, 14221, USA, Tel +1-716-531-4598, Fax +1-716-478-6917, Email sb25@buffalo.eduAbstract: Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder of the autonomic nervous system most commonly affecting women of reproductive age. Studies on POTS and pregnancy are limited, and there is a lack of clinical guidelines regarding assessment and management of pregnant women with POTS. The purpose of this review is to summarize data from the available studies on the topic of pregnancy in POTS and common comorbid conditions and to provide the clinical recommendations regarding evaluation and treatment of POTS in pregnant women, based on the available studies and clinical experience. We conclude that pregnancy appears to be safe for women with POTS and is best managed by a multi-disciplinary team with knowledge of POTS and its various comorbidities. Importantly, large, prospective studies are needed to better delineate the course and outcomes of pregnancy, as well as possible pregnancy-related complications in women with POTS. Clinicians should be aware of the clinical presentation, diagnostic criteria, and treatment options in pregnant women with POTS to optimize outcomes and improve medical care during pregnancy and post-partum period.Keywords: POTS, pregnancy, Ehlers-Danlos syndrome, migraine, post-partum