000			02769nam a22004697a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a0959-289X
024			_aNIHMS1991338 [mid]
024			_aPMC11227390 [pmc]
024			_aS0959-289X(24)00051-7 [pii]
040			_aOvid MEDLINE(R)
099			_a38781778
245			_aHow severity and classification of pulmonary hypertension affect pregnancy outcomes: a systematic review and timeline.
251			_aInternational Journal of Obstetric Anesthesia. 59:104210, 2024 Aug.
252			_aINT. J. OBSTET. ANESTH.. 59:104210, 2024 Aug.
253			_aInternational journal of obstetric anesthesia
260			_c2024
260			_fFY2024
260			_p2024 Aug
265			_sppublish
265			_tMEDLINE
266			_d2024-08-07
266			_z2024/05/23 18:09
520			_aWomen with pulmonary hypertension (PH) have increased mortality during pregnancy and the peripartum period. An increasing number of publications suggest improvements in maternal outcomes, so we conducted a systematic review focusing on disease severity and maternal survival. After screening 9097 potential studies from 1967 to 2021, we identified 66 relevant publications. Outcomes improved continuously over time and mortality fell from 11.6% in studies published before 2015 to 8.2% in studies published after 2015. Mortality was lower in patients with mild disease (0.8%) than in those with Eisenmenger syndrome (26.2%) or idiopathic pulmonary arterial hypertension (7.4-24.0%). One major drawback of the published studies is that they define severity using echocardiographic-estimated pulmonary artery pressures, without considering more contemporary parameters. This systematic review provides new insights for preconception counseling on pregnancy risks related to PH and suggests that PH classification and severity should be carefully considered in determining an individual's pregnancy-associated risk. Copyright © 2024 Elsevier Ltd. All rights reserved.
546			_aEnglish
650			_a*Hypertension, Pulmonary
650			_a*Pregnancy Complications, Cardiovascular
650			_a*Pregnancy Outcome
650			_a*Severity of Illness Index
650			_aFemale
650			_aHumans
650			_aHypertension, Pulmonary/co [Complications]
650			_aPregnancy
650			_zCurated
651			_aMedStar Union Memorial Hospital
657			_aJournal Article
657			_aSystematic Review
700			_aPham, E _bMUMH
790			_aCruz NC, Pham E, Ali H, Nanavati J, Steppan D, Kolb TM, Thomas AJ, Murphy J, Nyhan S, Grant MC, Steppan J
856			_uhttps://dx.doi.org/10.1016/j.ijoa.2024.104210 _zhttps://dx.doi.org/10.1016/j.ijoa.2024.104210
942			_cART _dArticle
999			_c14539 _d14539