Korean J Obstet Gynecol.  2010 Jan;53(1):63-69. 10.5468/kjog.2010.53.1.63.

A successful pregnancy in patient with pulmonary hypertension associated with systemic lupus erythematosus

• Jang DG
• Chong YJ
• Lee Y
• Lee G

• KMID: 2077962
• DOI: http://doi.org/10.5468/kjog.2010.53.1.63

Abstract

Pulmonary hypertension is a rare and potentially life-threatening complication of Systemic lupus erythematosus (SLE), and 5 cases has been previously documented in pregnancy. Four cases died after delivery and only one case was alive. We describe the case of a 28-year-old pregnant woman with pulmonary hypertension related to SLE with no previous history of immunologic disease including SLE. Diagnosis was made at 22 weeks of gestation. Medication including prednisolone and hydroxychloroquinone was commenced immediately and continued throughout the pregnancy. On fetal sonogram, the fetal growth was 3~10 percentile and diastolic notch of uterine arteries was noted. However, a healthy baby girl weighing 2,400 g was born in planned vaginal delivery at gestation week 38. There were no postpartum complications.

Keyword

Pregnancy; Systemic lupus erythematosus; Pulmonary hypertension; Intrauterine growth restriction

MeSH Terms

Adult
Female
Fetal Development
Humans
Hypertension
Hypertension, Pulmonary
Immune System Diseases
Lupus Erythematosus, Systemic
Postpartum Period
Prednisolone
Pregnancy
Pregnant Women
Uterine Artery
Prednisolone

Figure

• 

  Figure 1 Chest X-ray and Electrocardiogram on admission. Chest X-ray revealed cardiomegaly (cardiothoracic ratio >0.66) and mild pulmonary congestion. Electrocardiogram showed low voltage with normal sinus rhythm.

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  Figure 2 Doppler imaging to evaluate the bilateral uterine artery, MCA and umbilical artery for assessment of fetal health. (A) The early diastolic notching is noted at right uterine artery. (B) The early diastolic notching is noted at left uterine artery. (C) The umbilical artery shows normal velocities at 24 weeks of gestation. RI=0.69. (D) MCA shows high resistance and low diastolic velocities at 24 weeks of gestation. RI=0.82. (E) The umbilical artery shows an increase in diastolic velocities and a decline in RI (=0.54) at 33 weeks of gestation compared as that at 24 weeks of gestation. (F) MCA shows high diastolic velocities at 33 weeks of gestation. R=0.66.

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