Contraception and pregnancy

Pulmonary Hypertension during pregnancy

Pregnant women with obstructive pulmonary vascular disease, whether surgically corrected or not, face a heightened risk of death during childbirth or the immediate postpartum period. The exact cause of the elevated mortality in this patient group remains unclear. Notably, a particularly high mortality rate is observed in those undergoing cesarean sections, despite this procedure exerting less cardiovascular stress than spontaneous childbirth and vaginal delivery.

Regardless of the chosen birthing method, adherence to simple guidelines is crucial: maintaining continuous oxygen inhalation and avoiding inhalational anesthetics. Throughout labor and the early postoperative period, periodic monitoring of arterial gas tension, systemic blood pressure, and, if possible, pulmonary artery pressure is recommended.

For women with obstructive pulmonary vascular disease, some healthcare professionals may advise early abortions due to the high-risk nature of their pregnancies. These women should receive counseling from specialists, outlining the potential risks associated with pregnancy, childbirth, and the availability of contraception.

Contraception

• The use of intrauterine contraceptives should be avoided due to the associated risks of bleeding and infection.
• Prescribing oral contraceptives is contraindicated, as they may contribute to the development of pulmonary vascular thrombosis.
• Preference should be given to barrier methods of preventing pregnancy.

Preventing pregnancy in these patients is much safer than providing specific treatment and preventing potential complications during pregnancy, labor, childbirth, and the postpartum period.