Pulmonary arterial hypertension is a relatively uncommon disease. The disease is characterized by marked increases in the pressure found in the blood vessels of the lungs. This disease, when seen most commonly, occurs in women. As with many of the discussions involving pregnancy, this short article cannot cover all of the complexities. I will focus on some of the ways PAH impacts pregnancy and issues involved with treatment.
During pregnancy the heart pumps approximately 35% more blood with each contraction. This increase in cardiac output is normally well absorbed by the blood vessels of the lungs. Normal blood vessels will dilate and the pressure inside them stays the same. In PAH the blood vessels are stiff and cannot dilate well or at all. Therefore, this increase in blood volume being pushed through the lungs of PAH patients causes marked increases in pressure. This increased pressure greatly stresses the right side of the heart and can cause serious irreversible damage.
Women with PAH are advised not to become pregnant for their own safety, as well as the safety of their fetus. Additionally, the medications used to treat PAH have known serious effects on the fetus. In fact, women under treatment for PAH are expected to use two forms of birth control to prevent pregnancy and must submit to monthly pregnancy tests in order to get their medication.
PAH, although uncommon, poses a serious risk to a mother and her developing baby. Seek knowledgeable advice with this problem.