TY - JOUR T1 - Pregnancy outcomes in pulmonary arterial hypertension in the modern management era JF - European Respiratory Journal JO - Eur Respir J SP - 881 LP - 885 DO - 10.1183/09031936.00141211 VL - 40 IS - 4 AU - Xavier Jaïs AU - Karen M. Olsson AU - Joan A. Barbera AU - Isabel Blanco AU - Adam Torbicki AU - Andrew Peacock AU - C. Dario Vizza AU - Peter Macdonald AU - Marc Humbert AU - Marius M. Hoeper Y1 - 2012/10/01 UR - http://erj.ersjournals.com/content/40/4/881.abstract N2 - Previous studies have reported mortality rates of up to 56% associated with pregnancy in pulmonary arterial hypertension (PAH) but the management of this disease has changed considerably in recent years. We compiled a multinational, prospective registry to examine the contemporary outcome of pregnancies in patients with PAH. During a 3-yr period, the 13 participating centres reported 26 pregnancies. Three (12%) females died and one (4%) developed right heart failure requiring urgent heart–lung transplantation. There were eight abortions; two spontaneous and six induced. 16 (62%) pregnancies were successful, i.e. the females delivered healthy babies without complications. These females had well controlled PAH (pulmonary vascular resistance (PVR) 500±352 dyn·s·cm−5); eight of them were long-term responders to calcium channel blockers. In contrast, the females who died or required transplantation had poorly controlled PAH (PVR 1,667±209 dyn·s·cm−5). Pregnancy remains associated with a substantial mortality rate in PAH. However, our results indicate that the outcome of pregnancy in PAH has improved, at least when PAH is well controlled, and particularly in long-term responders to calcium channel blockers. These data must be confirmed by larger series before the general recommendation to avoid pregnancy in all patients with PAH is reconsidered. ER -