{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:40:50Z","timestamp":1753882850001,"version":"3.41.2"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medical Case Reports"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p> Little awareness persists of how pregnancy worsens cardiac diseases. We wish to highlight the challenges in managing pulmonary hypertension (PH) in pregnancy, within low socioeconomic environments. A 31-year-old G3P1A1 of 5\u2009months gestation presented with worsening dyspnea and extremital edema. She had a history of heart disease with no cardiologist follow-up. She was diagnosed with type I\/II PH at 4\u2009months gestation. Her ultrasound revealed intrauterine fetal death (IUFD). She was referred for pregnancy termination. At presentation, she was tachypneic with SaO<jats:sub>2<\/jats:sub> at 68%. After labor, she was transferred to a cardiac intensive care unit with SaO<jats:sub>2<\/jats:sub> at 60%. Bedside echocardiography revealed a high probability of PH (pulmonary artery systolic pressure value: 109\u2009mmHg). Unfortunately, she deteriorated and passed away a day later. Cardiac diseases in pregnancy contribute significantly to maternal mortality in Indonesia and other low socioeconomic countries. Traditional views on pregnancy and family and human rights advocate pregnancy as one of the rights, pregnancy complicated with cardiac diseases is detrimental and potentially lethal. Disparities in healthcare practices and low socioeconomic environments also contribute to such outcomes. Lack of awareness and improperly held beliefs on conception and family have led women to conceive amidst severe underlying cardiac diseases with dire outcomes. <\/jats:p>","DOI":"10.1177\/2050313x231201737","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T11:28:49Z","timestamp":1695727729000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dilemmas in pregnancies with pulmonary hypertension: Case report from a low-resource setting"],"prefix":"10.1177","volume":"11","author":[{"given":"Dini","family":"Pusianawati","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3049-5572","authenticated-orcid":false,"given":"Alfonsus Zeus","family":"Suryawan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin Dominique","family":"Tjandraprawira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte J","family":"Cool","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"key":"bibr1-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.5334\/gh.1133"},{"key":"bibr2-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.20473\/mog.V1I12019.17-23"},{"key":"bibr3-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X13495193"},{"key":"bibr4-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.04.012"},{"key":"bibr5-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20755"},{"key":"bibr6-2050313X231201737","first-page":"3150","author":"Regitz-Zagrosek V","year":"2011","journal-title":"Eur Heart J"},{"key":"bibr7-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-011-0219-9"},{"key":"bibr8-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.1999.1701"},{"volume-title":"Williams obstetrics, 26e","year":"2021","author":"Cunningham F","key":"bibr9-2050313X231201737"},{"key":"bibr10-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn597"},{"key":"bibr11-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.3591"},{"key":"bibr12-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.006144"},{"key":"bibr13-2050313X231201737","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02492.x"},{"volume-title":"Application of the technical guidance on the application of a human rights-based approach to the implementation of policies and programmes to reduce preventable maternal mortality and morbidity","year":"2014","author":"United Nation General Assembly","key":"bibr14-2050313X231201737"},{"key":"bibr15-2050313X231201737","unstructured":"White Ribbon Alliance. Respectful maternity care: the universal rights of childbearing women. 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