Hipertensión pulmonar en el embarazo. Revisión narrativa.

Palabras clave: Hipertensión pulmonar, Embarazo, Trabajo de parto, Periodo posparto

Resumen

La hipertensión pulmonar es una enfermedad con una alta carga de morbimortalidad; las gestantes con este diagnóstico deben recibir un abordaje multidisciplinario con el fin de realizar un tratamiento adecuado y oportuno, además, de acuerdo con la severidad del cuadro se definirá la conducta pertinente con el fin de disminuir desenlaces maternos fetales adversos.

Una recomendación para las pacientes con diagnóstico conocido que asisten a la consulta preconcepcional es la anticoncepción; sin embargo, en caso de darse de forma inadvertida, se debe ofrecer la terminación del embarazo en el primer trimestre. Si se decide continuar con el embarazo, se debe establecer un tratamiento farmacológico, vía del parto y manejo postparto de acuerdo con las condiciones maternas y severidad de la patología. Se recomienda observación en una unidad de cuidados intensivos durante el trabajo de parto y hasta una semana posterior a este, con el fin de detectar las complicaciones de forma temprana.

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Disciplinas:

Ginecología y Obstetricia, Medicina critica y cuidado intensivo

Referencias bibliográficas

Garg N, Martin S. Pulmonary Hypertension in Pregnancy. En: Hameed AB, Wolfe D, editors. Cardio obstetrics: a practical guide to care for pregnant cardiac patients. First edition. Boca Raton: CRC Press. 2020. p. 135-43. https://doi.org/10.1201/9780429454912

Sahni S, Palkar AV, Rochelson BL, Kępa W, Talwar A. Pregnancy and pulmonary arterial hypertension: A clinical conundrum. Pregnancy Hypertens Int J Womens Cardiovasc Health. 2015;5(2):157-64. https://doi.org/10.1016/j.preghy.2015.01.004

Olsson KM, Channick R. Pregnancy in pulmonary arterial hypertension. Eur Respir Rev. 2016; 25(142): 431-7. https://doi.org/10.1183/16000617.0079-2016

Sliwa K, van Hagen IM, Budts W, Swan L, Sinagra G, Caruana M, et al. Pulmonary hypertension and pregnancy outcomes: data from the Registry Of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology: Pulmonary hypertension in pregnancy. Eur J Heart Fail. 2016; 18(9): 1119-28. https://doi.org/10.1002/ejhf.594

Bedard E, Dimopoulos K, Gatzoulis MA. Has there been any progress made on pregnancy outcomes among women with pulmonary arterial hypertension? Eur Heart J. 2008; 30(3): 256-65. https://doi.org/10.1093/eurheartj/ehn597

Klinger JR, Elliott CG, Levine DJ, Bossone E, Duvall L, Fagan K, et al. Therapy for Pulmonary Arterial Hypertension in Adults. Chest. 2019; 155(3): 565-86. https://doi.org/10.1016/j.chest.2018.11.030

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. Pulm Circ. 2015; 5(3): 435-65. https://doi.org/10.1086/682230

Múnera-Echeverri AG. Heart disease and pregnancy. Rev Colomb Cardiol. 2018; 25:49-58. https://doi.org/10.1016/j.rccar.2017.11.028

Meng M-L, Landau R, Viktorsdottir O, Banayan J, Grant T, Bateman B, et al. Pulmonary Hypertension in Pregnancy: A Report of 49 Cases at Four Tertiary North American Sites. Obstet Gynecol. 2017;129(3):511-20. https://doi.org/10.1097/AOG.0000000000001896

Thomas CA, Anderson RJ, Condon DF, Perez VADJ. Diagnosis and Management of Pulmonary Hypertension in The Modern Era: Insights from the 6th World Symposium. Pulm Ther. 2020; 6(1): 9-22. https://doi.org/10.1007/s41030-019-00105-5

Ballard W, Dixon B, McEvoy CA, Verma AK. Pulmonary Arterial Hypertension in Pregnancy. Cardiol Clin. 2021; 39(1): 109-18. https://doi.org/10.1016/j.ccl.2020.09.007

Sahay S. Evaluation and classification of pulmonary arterial hypertension. J Thorac Dis. 2019; 11(S14): S1789–99. https://doi.org/10.21037/jtd.2019.08.54

Condon DF, Nickel NP, Anderson R, Mirza S, de Jesus Perez VA. The 6th World Symposium on Pulmonary Hypertension: what’s old is new. F1000Research. 2019; 8: F1000. https://doi.org/10.12688%2Ff1000research.18811.1

Beshay S, Sahay S, Humbert M. Evaluation and management of pulmonary arterial hypertension Respir Med. 2020; 171:106099. https://doi.org/10.1016/j.rmed.2020.106099

Simonneau G, Montani D, Celermajer DS, Denton CP, Gatzoulis MA, Krowka M, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J. 2019; 53(1). https://doi.org/10.1183/13993003.01913-2018

Galiè N, McLaughlin VV, Rubin LJ, Simonneau G. An overview of the 6th World Symposium on Pulmonary Hypertension. Eur Respir J. 2019; 53(1): 1802148. https://doi.org/10.1183/13993003.02148-2018

Brown LM, Chen H, Halpern S, Taichman D, McGoon MD, Farber HW, et al. Delay in Recognition of Pulmonary Arterial Hypertension. Chest. 2011; 140(1):19-26. https://doi.org/10.1378/chest.10-1166

Galiè N, Humbert M, Vachiery J-L, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).Eur Respir J. 2015; 46(4): 903-75. https://doi.org/10.1183/13993003.01032-2015

Frost A, Badesch D, Gibbs JSR, Gopalan D, Khanna D, Manes A, et al. Diagnosis of pulmonary hypertension. Eur Respir J. 2019; 53(1): 1801904. https://doi.org/10.1183/13993003.01904-2018

Lane CR, Trow TK. Pregnancy and Pulmonary Hypertension. Clin Chest Med. 2011; 32(1): 165-74. https://doi.org/10.1016/j.ccm.2010.10.006

Martin SR, Edwards A. Pulmonary Hypertension and Pregnancy: Obstet Gynecol. 2019; 134(5): 974–87. https://doi.org/10.1097/AOG.0000000000003549

Zaidan MF, Duarte AG. Pulmonary Hypertension in Pregnancy. En: Phelan JP, editor. Critical care obstetrics. 6th edition. Hoboken, NJ, USA: Wiley-Blackwell; 2018. p. 775-90.

Pieper PG, Hoendermis ES. Pregnancy in women with pulmonary hypertension. Neth Heart J. 2011; 19(12): 504-8. https://doi.org/10.1007/s12471-011-0219-9

Zagolin M, Llancaqueo M. Pulmonary hypertension: importance of early diagnosis and specific treatment. Rev Médica Clínica Las Condes. 2015; 26(3): 344–56. https://doi.org/10.1016/j.rmclc.2015.06.009

Pieper PG, Lameijer H, Hoendermis ES. Pregnancy and pulmonary hypertension. Best Pract Res Clin Obstet Gynaecol. 2014; 28(4): 579–91. https://doi.org/10.1016/j.bpobgyn.2014.03.003

Marín R, de la Sierra A, Armario P, Campo C, Banegas JR, Gorostidi M, et al. [2005 Spanish guidelines in diagnosis and treatment of arterial hypertension].Med Clin (Barc). 2005; 125(1): 24-34. https://doi.org/10.1157/13076402

Elkayam U, Goland S, Pieper PG, Silversides CK. High-Risk Cardiac Disease in Pregnancy. J Am Coll Cardiol. 2016; 68(5): 502–16. https://doi.org/10.1016/j.jacc.2016.05.050

Duarte AG, Thomas S, Safdar Z, Torres F, Pacheco LD, Feldman J, et al. Management of Pulmonary Arterial Hypertension During Pregnancy. Chest. 2013; 143(5): 1330-6. https://doi.org/10.1378/chest.12-0528

Moreno-Escallón B. Vaginal misoprostol in pregnant low risk outpatients at term for selective induction of labor. Cohort Study. Rev Colomb Obstet Ginecol. 2012;63(1):64–72. https://doi.org/10.18597/rcog.204

Lopez M, Gracia M, Martínez-Ocón J, Blanco I. Manejo obstétrico-ginecológico en pacientes con hipertensión pulmonar [Internet]. Barcelona, España. Clinic Barcelona Hospital Universitario; 2020 [Consultado: 21 enero 2021]. Disponible en: https://docs.google.com/viewerng/viewer?url=https://medicinafetalbarcelona.org/protocolos/es/patologia-materna-obstetrica/hipertension-pulmonar.pdf

Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, De Bonis M, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 201; 39(34): 3165-241. https://doi.org/10.1093/eurheartj/ehy340.

Asociación Argentina de Medicina Respiratoria. Guías Argentinas de Consenso en Diagnóstico y Tratamiento de la Hipertensión Pulmonar. Revista Americana de Medicina Respiratoria. 2017; 17(4): 266-336. Disponible en: https://www.aamr.org.ar/recursos_educativos/consensos/guias_arg_consenso_hp_ramr_2017.pdf

Kramer Mordechai. Pulmonary Hypertension and Pregnancy: Management and Outcome. Journal of Pulmonary & Respiratory Medicine. 2013; 10.4172/2161-105X.S4-004. http://dx.doi.org/10.4172/2161-105X.S4-0047

Madden BP. Pulmonary hypertension and pregnancy. Int J Obstet Anesth. 2009; 18(2): 156-64. https://doi.org/10.1016/j.ijoa.2008.10.006

Banerjee D, Ventetuolo C. Pulmonary Hypertension in Pregnancy. Semin Respir Crit Care Med. 2017; 38(02): 148-59. https://doi.org/10.1055/s-0037-1602242.

Castillo-Luna R, Miranda-Araujo O. Obstetric management in patients with severe pulmonary hypertension. Ginecol Obstet Mex. 2015; 83(12): 785–97.

Običan SG, Cleary KL. Pulmonary arterial hypertension in pregnancy. Semin Perinatol. 2014; 38(5): 289–94. https://doi.org/10.1053/j.semperi.2014.04.018

Arendt KW, Lindley KJ. Obstetric anesthesia management of the patient with cardiac disease. Int J Obstet Anesth. 2019; 37: 73–85. https://doi.org/10.1016/j.ijoa.2018.09.011

Cómo citar
(1)
Peláez-Henao, J. G.; Bello-Muñoz, C. A. Hipertensión Pulmonar En El Embarazo. Revisión Narrativa. Rev. Fac. Cienc. Salud Univ. Cauca 2022, 24.
Publicado
2022-06-16
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