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British Journal of Anaesthesia, 2001, Vol. 87, No. 2 295-298
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Primary pulmonary hypertension in pregnancy; a role for novel vasodilators

L. Monnery1, J. Nanson2 and G. Charlton3

1Department of Anaesthesia, Dorset County Hospital, Williams Avenue, Dorchester DT1 2JY, UK. 2Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. 3Shackleton Department of Anaesthetics, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK*Corresponding author

We describe the case of a 28-week pregnant woman presenting with severe primary pulmonary hypertension (PPH). She had an elective Caesarean section under general anaesthesia at 32 weeks gestation. Pulmonary artery pressures (PAP) measured from a pulmonary artery catheter before anaesthesia were in excess of 100 mm Hg. Intraoperative nitric oxide was used to reduce PAP. After the delivery of a healthy infant PAP was controlled with nebulized iloprost and a prostacyclin infusion. Seven days later she was discharged from intensive care taking an oral calcium antagonist and warfarin. She developed intractable right heart failure and died 14 days after delivery. Despite increasing experience in the use of drugs to reduce PAP, the clinical course of pregnancy complicated by severe PPH is usually fatal.

Br J Anaesth 2001; 87: 295–8


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