Drugs for Pulmonary Hypertension in Pregnancy: What Should We Consider?

Abstract

Pulmonary Arterial Hypertension (PAH) is a disease characterized by narrowing of the pulmonary arteries and increased vascular resistance cause to increase morbidity and mortality. Women with PAH should avoid becoming pregnant because changes in physiological, cardiovascular dan pulmonary can affect the condition. If these women decide to continue their pregnancy, they have several treatment options: inhaled nitric oxide, calcium channel blocker, and sildenafil. Endothelin receptor antagonists like bosentan, macitentan, ambrisentan are contraindicated. Sildenafil is categorized as a B drug in pregnant patients with PAH. Sildenafil causes vasodilatation in the pulmonary vascular beds and systemic circulation. Iloprost is a pregnancy category C but has beneficial in treating pregnant patients with PAH with no congenital abnormality and increased mortality in mother and infant. Epoprostenol, a potent pulmonary vasodilator categorized as a B drug but unfortunately not available in Indonesia.