Maternal Outcome in Pregnancy Complicated With Pulmonary Arterial Hypertension
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概要
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Background: Pulmonary arterial hypertension (PAH), including Eisenmenger syndrome, has a risk of mortality in pregnancy of 10–40%. The aim of this study was to investigate whether pulmonary artery blood pressure (PABP) is a prognostic factor for pregnancy outcome in patients with PAH. Methods and Results: The subjects were 42 patients with PAH during pregnancy. Severe and mild cases were defined by PABP before and during the first 14 weeks of pregnancy, with severe cases having mean PABP >40mmHg by catheterization or systolic PABP >50mmHg on echocardiography. Eighteen women chose termination of pregnancy before 14 weeks, leaving 24 women (10 mild, 14 severe) for analysis. The women with severe PAH delivered earlier (35.4 vs. 31.5 weeks, P<0.05) and had higher rates of small-for-gestational-age infants (0/10 vs. 7/14, P<0.01). Among the women with severe PAH, the New York Heart Association class dropped by 1 in 9 cases, by 2 in 3 cases, and remained the same in 2 cases as pregnancy progressed, whereas among the women with mild PAH, the class dropped by 1 in 1 case and 9 women remained in the same class. Among the severe cases, 1 woman died and there was 1 fetal death; PABP markedly increased in later pregnancy from 54 to 74mmHg (catheter measurement) and from 78 to 93mmHg (echocardiography) (P<0.05). Conclusions: The level of PABP before or in the early stage of pregnancy is an important predictor of pregnancy outcome. (Circ J 2012; 76: 2249–2254)
- 2012-08-25
著者
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Kamiya Chizuko
Department Of Perinatology National Cardiovascular Center
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Kamiya Chizuko
Department Of Medicine National Cardiovascular Center
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Kamiya Chizuko
Cardiovascular Division Of Internal Medicine National Cardiovascular Center
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Niwa Koichiro
Department Of Adult Chd Chiba Cardiovascular Center
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Niwa Koichiro
Department Of Adult Congenital Heart Disease And Pediatrics
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Kawasoe Yasutaka
Department Of Adult Congenital Heart Disease And Pediatric Cardiology Chiba Cardiovascular Center
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Niwa Koichiro
Department Of Adult Congenital Heart Disease And Pediatric Cardiology Chiba Cardiovascular Center
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Niwa Koichiro
Committee On Guideline For Prevention And Management Of Infective Endocarditis Japanese Circulation
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Ikeda Tomoaki
Department Of Obsterics And Gyneclogy Miyazaki Medical College University Of Miyazaki
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Yoshimatsu Jun
Department Of Obstetrics & Gynecology Oita Medical University
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Nakanishi Norifumi
Department Of Cardiology Jichi Medical School
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Ueda Keiko
Department Of Biosystems Science Graduate School Of Science And Technology Kobe University
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Neki Reiko
Department Of Perinatology National Cardiovascular Center
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Takagi Yaemi
Department Of Cardiology Ehime Prefectural Central Hospital
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Yamanaka Kaoru
Department Of Electronic Engineering Institute Of Vocational Training
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Niwa Koichiro
Departments Of Pediatrics Chiba Cardiovascular Center
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Kawamata Kazuya
Department Of Perinatology National Cardiovascular Center:department Of Obstetrics And Gynecology Fa
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Katsuragi Shinji
Department Of Perinatology National Cardiovascular Center
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Sasaki Yoshihito
Department Of Obstetrics And Gynecology Asahikawa Medical College
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Neki Reiko
Department Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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MIYOSHI Takekazu
National Cerebral and Cardiovascular Center
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UEDA Keiko
National Cerebral and Cardiovascular Center
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IKEDA Tomoaki
National Cerebral and Cardiovascular Center
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Nakanishi Norifumi
Department Of Cardiovascular Internal Medicine National Cerebral And Cardiovascular Center
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OSATO Kazuhiro
Departments of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
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Osato Kazuhiro
Departments Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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Neki Reiko
Departments Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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Sasaki Yoshihito
Departments Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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Kawasaki Kaoru
Departments Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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MIYOSHI Takekazu
Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
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HORIUCHI Chinami
Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
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KOBAYASHI Yoshinari
Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
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OGO Takeshi
Department of Cardiovascular Medicine, Pulmonary Circulation Group
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Ogo Takeshi
Department Of Cardiovascular Medicine Pulmonary Circulation Group
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Horiuchi Chinami
Department Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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Kobayashi Yoshinari
Department Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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Yoshimatsu Jun
Department Of Perinatology And Gynecology National Cerebral And Cardiovascular Center
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IKEDA Tomoaki
Deparartment of Perinatology, National Cardiovascular Center
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UEDA Keiko
Deparartment of Perinatology, National Cardiovascular Center
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KATSURAGI Shinji
Deparartment of Perinatology, National Cardiovascular Center
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TAKAGI Yaemi
Department of Cardiovascular Medicine, Pulmonary Circulation Group
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OSATO Kazuhiro
Department of Obstetrics and Gynecology, Department of Pathology, Faculty of Medicine, University of Miyazaki
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