A rare case of severe pulmonary hypertension in pregnancy

Ramna Banerjee, Farheen Rahman


Heart diseases in pregnancy have always been a source of major concern for both the patients as well as the caregivers because of the high risk of maternal morbidity and mortality and the need for specialist care by a multidisciplinary team preferably in a tertiary care hospital. Amongst the whole gamut of heart diseases, pulmonary hypertension is associated with high maternal morbidity and mortality (in the order of 20% in some studies) and hence is considered a contraindication for pregnancy. We report a rare case of a lady at 36 weeks gestation in her second pregnancy, with a previous caesarean section, who was incidentally diagnosed with severe pulmonary hypertension (PAP-110 mmHg) during her antenatal check-up in the third trimester of pregnancy and survived without any major complications after being promptly referred to and treated in a multispecialty hospital. Her previous pregnancy was absolutely uneventful and even in this pregnancy she had very mild symptoms as compared to the severity of the disease found on further investigation.


Primary pulmonary hypertension, Echocardiography, Multidisciplinary

Full Text:



Pieper PG, Hoendermis ES. Pregnancy in women with pulmonary hypertension. Neth Heart J. 2011;19:504-8.

Olsson KM, Channick R. Pregnancy in pulmonary arterial hypertension. Eur Respir Rev. 2016;25(142): 431-7.

Rubin LJ. Primary pulmonary hypertension. N Engl J Med. 1997;336:111-7.

Smith JS, Mueller J, Daniels CJ. Pulmonary arterial hypertension in the setting of pregnancy: a case series and standard treatment approach. Lung. 2012;190(2):155-60.

Bonnin M, Mercier FJ, Sitbon O, Roger-Christoph S, Jaïs X, Humbert M, et al. Severe pulmonary hypertension during pregnancy: mode of delivery and anesthetic management of 15 consecutive cases. Anesthesiology. 2005;102(6):1133-7.

Duarte AG, Thomas S, Safdar Z, Torres F, Pacheco LD, Feldman J, et al. Management of pulmonary arterial hypertension during pregnancy: a retrospective, multicenter experience. Chest. 2013;143(5):1330-6.

Roberts NV, Keast PJ. Pulmonary hypertension and pregnancy-a lethal combination. Anaesth Intensive Care. 1990;18:366-74.