# Delivery in a Pregnant Woman With Pulmonary Arterial Hypertension (PAH): A Case Report

## TL;DR

A pregnant woman with heart defects and high blood pressure in her lungs had a successful cesarean delivery with specialized care.

## Contribution

This case report highlights the successful management of a high-risk pregnancy complicated by pulmonary arterial hypertension and atrial septal defect.

## Key findings

- The patient underwent an elective cesarean section in a cardiosurgery operating room with ECMO access.
- The newborn had a good outcome with a 10-point Apgar score.
- The patient remained stable and did not require emergency interventions post-delivery.

## Abstract

Cardiovascular diseases in pregnant women are a challenge in pregnancy and perinatal care, representing a significant cause of perinatal death among this population. In this case report, we describe a 41-year-old pregnant woman with atrial septal defect (ASD) type II, 30 mm in size, and secondary pulmonary arterial hypertension (PAH), who was admitted to the Department of Obstetrics and Perinatology for delivery at 35+5 weeks of her first pregnancy. During the first trimester, the patient's attending cardiologist decided to use a wearable cardioverter defibrillator on the patient until the end of the pregnancy and postpartum. At 36+0 weeks of pregnancy, the pregnancy was finished by elective cesarean section by an experienced obstetric and anesthetic team in a cardiosurgery operating room with extracorporeal membrane oxygenation (ECMO) access. The patient remained hemodynamically stable in time, and after the procedure, the newborn received 10 pt. Apgar. After the procedure and during the hospitalization until hospital discharge, the patient did not require emergency interventions. In conclusion, women with PAH should be advised against becoming pregnant, but if a woman becomes pregnant and does not consent to terminate the pregnancy, advanced multidisciplinary care should be provided.