Pregnancy and Contraception in Patients with Pulmonary Arterial Hypertension

Abstract

The risk for complications and death associated with pregnancy in patients with pulmonary hypertension remains prohibitive. This chapter will review the physiological changes associated with pregnancy, past and current reported experience in pregnancy associated with pulmonary arterial hypertension (PAH), the management of patients with PAH during pregnancy, and finally, the approach to contraception in patients with PAH. In general, the hemodynamic issues and outcomes in pregnancy associated with PAH are similar despite the primary cause of PAH. Thus, pregnancy in idiopathic PAH (i.PAH), PAH related to congenital heart disease (PAH-CHD), and connective tissues diseases are considered together unless noted.