MATERNAL AND FETAL OUTCOMES OF PULMONARY HYPERTENSION IN WOMEN WITH CHRONIC HEART FAILURE DURING PREGNANCY: A CLINICAL PERSPECTIVE FROM BALOCHISTAN

Abstract

Pulmonary hypertension (PH) in women with chronic heart failure (CHF) during pregnancy represents a critical clinical challenge, particularly in resource‑limited regions such as Balochistan. Maternal cardiovascular and fetal jeopardy can lead to severe adverse outcomes, however, there is paucity of regional studies on the subject. The current study focuses on PH within CHF and describes outcomes for the mother and the fetus in Balochistan and focuses on the clinical challenges. We collected data for the study from tertiary care institutions in Balochistan and made a retrospective analysis of the records of pregnant women with CHF and PH. We studied the occurrence of preeclampsia, cardiac arrythmias, exacerbation of CHF, maternal mortality and other complications that can occur during pregnancy as the attributes of the mother. For the fetus, intrauterine growth restriction (IUGR), preterm delivery, low birth weight and fetal/neonatal mortality were studied. Our results indicate that there is a significant increase in maternal morbidity with heart failure decompensations and maternal mortality in the PH pregnancies, in comparison to those pregnancies where PH is absent. Our results also indicate that there is a significant increase in IUGR, preterm delivery and neonatal deaths. This is in addition to the increased overall risks that are present without proper obstetric and cardiology services. In Balochistan, maternal and fetal consequences remain severe and negative concerning the combination of pulmonary hypertension and chronic heart failure during pregnancy. To minimize this involvement, there should be early detection, the involvement of multiple specialties, and the use of advanced health systems. This study highlights the important lack of proper guidelines in this field and the need for targeted funding to enhance the survival of and care provided to mothers and babies.