Statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research Institute

Anna R. Hemnes, David G. Kiely, Barbara A. Cockrill, Zeenat Safdar, Victoria J. Wilson, Manal Al Hazmi, Ioana R. Preston, Mandy R. Maclean, Tim Lahm

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Pregnancy outcomes in patients with pulmonary hypertension remain poor despite advanced therapies. Although consensus guidelines recommend against pregnancy in pulmonary hypertension, it may nonetheless occasionally occur. This guideline document sought to discuss the state of knowledge of pregnancy effects on pulmonary vascular disease and to define usual practice in avoidance of pregnancy and pregnancy management. This guideline is based on systematic review of peer-reviewed, published literature identified with MEDLINE. The strength of the literature was graded, and when it was inadequate to support high-level recommendations, consensus-based recommendations were formed according to prespecified criteria. There was no literature that met standards for high-level recommendations for pregnancy management in pulmonary hypertension. We drafted 38 consensus-based recommendations on pregnancy avoidance and management. Further, we identified the current state of knowledge on the effects of sex hormones during pregnancy on the pulmonary vasculature and right heart and suggested areas for future study. There is currently limited evidence-based knowledge about both the basic molecular effects of sex hormones and pregnancy on the pulmonary vasculature and the best practices in contraception and pregnancy management in pulmonary hypertension. We have drafted 38 consensus-based recommendations to guide clinicians in these challenging topics, but further research is needed in this area to define best practices and improve patient outcomes.

LanguageEnglish
Pages435-465
Number of pages31
JournalPulmonary Circulation
Volume5
Issue number3
DOIs
Publication statusPublished - 1 Sep 2015

Fingerprint

Pulmonary Hypertension
Blood Vessels
Pregnancy
Lung
Consensus
Gonadal Steroid Hormones
Guidelines
Practice Guidelines
Peer Review
Pregnancy Outcome
Contraception
Vascular Diseases
MEDLINE
Lung Diseases
Research

Keywords

  • pulmonary hypertension
  • pregnancy
  • pulmonary vascular disease

Cite this

Hemnes, A. R., Kiely, D. G., Cockrill, B. A., Safdar, Z., Wilson, V. J., Hazmi, M. A., ... Lahm, T. (2015). Statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research Institute. 5(3), 435-465. https://doi.org/10.1086/682230
Hemnes, Anna R. ; Kiely, David G. ; Cockrill, Barbara A. ; Safdar, Zeenat ; Wilson, Victoria J. ; Hazmi, Manal Al ; Preston, Ioana R. ; Maclean, Mandy R. ; Lahm, Tim. / Statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research Institute. 2015 ; Vol. 5, No. 3. pp. 435-465.
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Hemnes, AR, Kiely, DG, Cockrill, BA, Safdar, Z, Wilson, VJ, Hazmi, MA, Preston, IR, Maclean, MR & Lahm, T 2015, 'Statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research Institute' vol. 5, no. 3, pp. 435-465. https://doi.org/10.1086/682230

Statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research Institute. / Hemnes, Anna R.; Kiely, David G.; Cockrill, Barbara A.; Safdar, Zeenat; Wilson, Victoria J.; Hazmi, Manal Al; Preston, Ioana R.; Maclean, Mandy R.; Lahm, Tim.

Vol. 5, No. 3, 01.09.2015, p. 435-465.

Research output: Contribution to journalArticle

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Hemnes AR, Kiely DG, Cockrill BA, Safdar Z, Wilson VJ, Hazmi MA et al. Statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research Institute. 2015 Sep 1;5(3):435-465. https://doi.org/10.1086/682230