{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:08:46Z","timestamp":1789420126779,"version":"build-2803163510"},"reference-count":74,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T00:00:00Z","timestamp":1678060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Pulmonary arterial hypertension (PAH) is defined as an elevated mean pulmonary artery pressure (mPAP) of &gt;20 mmHg together with a pulmonary arterial wedge pressure (PAWP) of \u226415 mmHg and pulmonary vascular resistance (PVR) of&gt;2 Wood units (WU). Although the total mortality of pregnant women with PAH has decreased significantly in recent years and is reported to be around 12% in some databases, total mortality is still at an unacceptably high percentage. Moreover, some subgroups, such as patients with Eisenmenger\u2019s syndrome, have a particularly high mortality rate of up to 36%. Pregnancy in patients with PAH is contraindicated; its appearance is an indication for a planned termination. Education of patients with PAH, including counseling on effective contraception, is essential. During pregnancy, blood volume, heart rate, and cardiac output increase, while PVR and systemic vascular resistance decrease. The hemostatic balance is shifted towards hypercoagulability. Among PAH-specific drugs, the use of inhaled or intravenous prostacyclins, phosphodiesterase inhibitors, and calcium channel blockers (in patients with preserved vasoreactivity) is acceptable. Endothelin receptor antagonists and riociguat are contraindicated. Childbirth can take place through either vaginal delivery or caesarean section; similarly, neuraxial and general anesthesia have proven indications. In a situation where all pharmacological options have been used in pregnant or postpartum patients in a serious condition, veno-arterial ECMO is a useful therapeutic option. For PAH patients who want to become mothers, an option that does not endanger their lives is adoption.<\/jats:p>","DOI":"10.3390\/ijerph20054625","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T03:49:08Z","timestamp":1678074548000},"page":"4625","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Pregnancy in Patients with Pulmonary Arterial Hypertension in Light of New ESC Guidelines on Pulmonary Hypertension"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4846-5598","authenticated-orcid":false,"given":"Karolina","family":"Bara\u0144ska-Pawe\u0142czak","sequence":"first","affiliation":[{"name":"Department of Cardiology, Specialistic Hospital in Zabrze, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3700-8439","authenticated-orcid":false,"given":"Celina","family":"Wojciechowska","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1091-9788","authenticated-orcid":false,"given":"Wojciech","family":"Jache\u0107","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,6]]},"reference":[{"key":"ref_1","first-page":"ehac237","article-title":"ESC\/ERS Scientific Document Group, 2022 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: Developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG)","volume":"43","author":"Humbert","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3165","DOI":"10.1093\/eurheartj\/ehy340","article-title":"2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy","volume":"39","author":"Bauersachs","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1016\/S0735-1097(98)00162-4","article-title":"Outcome of pulmonary vascular disease in pregnancy: A systematic overview from 1978 through 1996","volume":"31","author":"Weiss","year":"1998","journal-title":"J. Am. Coll.Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20458940211013671","DOI":"10.1177\/20458940211013671","article-title":"Pulmonary arterial hypertension in pregnancy-a systematic review of outcomes in the modern era","volume":"11","author":"Low","year":"2021","journal-title":"Pulm. Circ."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Duan, R., Xu, X., Wang, X., Yu, H., You, Y., Liu, X., Xing, A., Zhou, R., and Xi, M. (2016). Pregnancy outcome in women with Eisenmenger\u2019s syndrome: A case series from west China. BMC PregnancyChildbirth, 16.","DOI":"10.1186\/s12884-016-1153-z"},{"key":"ref_6","first-page":"256","article-title":"Has there been any progress made on pregnancy outcomes among women with pulmonary arterial hypertension?","volume":"30","author":"Dimopoulos","year":"2009","journal-title":"Eur. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1183\/09031936.00141211","article-title":"Pregnancy outcomes in pulmonary arterial hypertension in the modern management era","volume":"40","author":"Olsson","year":"2012","journal-title":"Eur. Respir. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.ijcard.2020.10.021","article-title":"Incidence and long-term outcomes of pregnant women complicated with pulmonary arterial hypertension during different pregnancies: A prospective cohort study from China","volume":"326","author":"Yang","year":"2021","journal-title":"Int. J.Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.preghy.2017.09.001","article-title":"Risk factors for perinatal cardiac complications in pregnancy with pulmonary hypertension","volume":"12","author":"Zhao","year":"2018","journal-title":"Pregnancy Hypertens"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e12079","DOI":"10.1002\/pul2.12079","article-title":"Maternal and fetal outcomes of pregnant women with pulmonary arterial hypertension associated with congenital heart disease in Beijing, China: A retrospective study","volume":"12","author":"Liu","year":"2022","journal-title":"Pulm. Circ."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1801899","DOI":"10.1183\/13993003.01899-2018","article-title":"Genetics and genomics of pulmonary arterial hypertension","volume":"53","author":"Morrell","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1007\/s10508-022-02284-w","article-title":"Sexual and Reproductive Health in Women with Pulmonary Hypertension: A Qualitative Study","volume":"51","author":"Cipolletta","year":"2022","journal-title":"Arch. Sex Behav."},{"key":"ref_13","unstructured":"Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, and Centers for Disease Control and Prevention (CDC) (2013). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: Adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm. Rep., 62, 1\u201360."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/AOG.0000000000000911","article-title":"Contraceptive Use and Unintended Pregnancy in Women with Congenital Heart Disease","volume":"126","author":"Lindley","year":"2015","journal-title":"Obs. Gynecol."},{"key":"ref_15","first-page":"2045894018785259","article-title":"EXPRESS: Intimacy, Contraception, and Pregnancy Prevention in Patients with Pulmonary Arterial Hypertension: Are We Counseling Our Patients?","volume":"10","author":"Hill","year":"2018","journal-title":"Pulm. Circ."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1783\/147118906776276486","article-title":"Pregnancy and contraception in heart disease and pulmonary arterial hypertension","volume":"32","author":"Thorne","year":"2006","journal-title":"J. Fam.Plann. Reprod. Health Care."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1053\/euhj.1999.1701","article-title":"Pulmonary vascular disease and pregnancy: Current controversies, management strategies, and perspectives","volume":"21","author":"Weiss","year":"2000","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1097\/00000542-200212000-00045","article-title":"Pregnant patient with primary pulmonary hypertension: General anesthesia and extracorporeal membrane oxygenation support for termination of pregnancy","volume":"97","author":"Satoh","year":"2002","journal-title":"Anesthesiology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/00000542-196507000-00004","article-title":"Changes in The Blood Volume during Pregnancy and Delivery","volume":"26","author":"Pritchard","year":"1965","journal-title":"Anesthesiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1161\/01.CIR.58.3.434","article-title":"Effects of a natural volume overload state (pregnancy) on left ventricular performance in normal human subjects","volume":"58","author":"Katz","year":"1978","journal-title":"Circulation"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1161\/01.CIR.99.4.511","article-title":"Left ventricular diastolic function in normal human pregnancy","volume":"99","author":"Mesa","year":"1999","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1016\/0002-9378(89)90900-9","article-title":"Central hemodynamic assessment of normal term pregnancy","volume":"161","author":"Clark","year":"1989","journal-title":"Am. J.Obs. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1136\/heartjnl-2015-308476","article-title":"Cardiac output and related haemodynamics during pregnancy: A series of meta-analyses","volume":"102","author":"Meah","year":"2016","journal-title":"Heart"},{"key":"ref_24","first-page":"438","article-title":"Analysis of hemodynamics and outcomes of pregnant women with congenital heart disease-pulmonary arterial hypertension","volume":"54","author":"Zhang","year":"2019","journal-title":"Zhonghua Fu Chan Ke Za Zhi"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/S0002-9149(97)00047-7","article-title":"Incidence of arrhythmias in normal pregnancy and relation to palpitations, dizziness, and syncope","volume":"79","author":"Shotan","year":"1997","journal-title":"Am. J. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1161\/01.HYP.38.3.746","article-title":"Time-qualified reference values for ambulatory blood pressure monitoring in pregnancy","volume":"38","author":"Hermida","year":"2001","journal-title":"Hypertension"},{"key":"ref_27","first-page":"395","article-title":"Blood pressure survey in pregnancy","volume":"37","author":"MacGillivray","year":"1969","journal-title":"Clin. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1055\/s-2003-38897","article-title":"Hemostasis during normal pregnancy and puerperium","volume":"29","author":"Hellgren","year":"2003","journal-title":"Semin. Thromb.Hemost."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/j.1742-1241.2011.02711.x","article-title":"The management of pregnancy and pregnancy-related medical conditions in pulmonary arterial hypertension patients","volume":"172","author":"Hsu","year":"2011","journal-title":"Int. J. Clin. Pr. Suppl."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"European Society of Gynecology (ESG), Association for European Paediatric Cardiology (AEPC), German Society for Gender Medicine (DGesGM), Regitz-Zagrosek, V., Blomstrom Lundqvist, C., Borghi, C., Cifkova, R., Ferreira, R., Foidart, J.M., and Gibbs, J.S. (2011). ESC Guidelines on the management of cardiovascular diseases during pregnancy: The Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur. Heart J., 32, 3147\u20133197.","DOI":"10.1093\/eurheartj\/ehr218"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"286","DOI":"10.4266\/acc.2021.00458","article-title":"Critical care management of pulmonary arterial hypertension in pregnancy: The pre-, peri- and post-partum stages","volume":"36","author":"Phoophiboon","year":"2021","journal-title":"Acute Crit. Care."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1136\/hrt.68.12.540","article-title":"Adaptation of the maternal heart in pregnancy","volume":"68","author":"Hunter","year":"1992","journal-title":"Br. Heart J."},{"key":"ref_33","unstructured":"(2022, October 01). Amlodipine Besylate FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2011%2F019787s047lbl.pdf&usg=AOvVaw1bzMQHdiUF6xhlQiY8LC-F."},{"key":"ref_34","unstructured":"(2022, October 01). Nifedipine FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2013%2F018482s051lbl.pdf&usg=AOvVaw2WX4ugufcP-r-RQ5Tqy3q1."},{"key":"ref_35","unstructured":"(2022, October 01). Diltiazem Hydrochloride FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2014%2F018602s065lbl.pdf&usg=AOvVaw0Ss3cAa0aLtUylctHK_d0-."},{"key":"ref_36","unstructured":"(2022, October 01). Sildenafil FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2011%2F020895s036lbl.pdf&usg=AOvVaw1KhihEPiWQc92y4b5UNdAX."},{"key":"ref_37","unstructured":"(2022, October 01). Tadalafil FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2011%2F021368s20s21lbl.pdf&usg=AOvVaw3rkxXrjRh_TgClRzvaDHMG."},{"key":"ref_38","unstructured":"(2022, October 01). Ambrisentan FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2018%2F022081s040lbl.pdf&usg=AOvVaw0rJrBJyCisN8ne0Wdt0Fqx."},{"key":"ref_39","unstructured":"(2022, October 01). Bosentan FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2017%2F209279s000lbl.pdf&usg=AOvVaw0dHdxlL3CNDJAdTdFH0aE_."},{"key":"ref_40","unstructured":"(2022, October 01). Macitentan FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2019%2F204410s017lbl.pdf&usg=AOvVaw0OoTrfi1RqokR3Sk0Qqja7."},{"key":"ref_41","unstructured":"(2022, October 01). Iloprost FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2009%2F021779s009lbl.pdf&usg=AOvVaw1awsKukjMNz-H2Q92KXtWn."},{"key":"ref_42","unstructured":"(2022, October 01). Epoprostenol FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2012%2F022260s005lbl.pdf&usg=AOvVaw2gz1ScpY2hWcVn7tTSFHLb."},{"key":"ref_43","unstructured":"(2022, October 01). Treprostinil FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2018%2F021272s026lbl.pdf&usg=AOvVaw3JItWhOOWwneX63ULEgTy3."},{"key":"ref_44","unstructured":"(2022, October 01). Oral Treprostinil FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2013%2F203496s000lbl.pdf&usg=AOvVaw21R5jakNqFrm0ztVggVWOV."},{"key":"ref_45","unstructured":"(2022, October 01). Inhaled Treprostinil FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2009%2F022387lbl.pdf&usg=AOvVaw3KQxEGFHRaZEn0wkRv_FyS."},{"key":"ref_46","unstructured":"(2022, October 01). Selexipag FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2015%2F207947s000lbl.pdf&usg=AOvVaw3uiiH0ih6RoxmJqVsRGJIQ."},{"key":"ref_47","unstructured":"(2022, October 01). Riocuguat FDA Label, Available online: https:\/\/www.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2017%2F204819s006lbl.pdf&usg=AOvVaw2dYaZayTn1WQNm9qm7RLdE."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1053\/j.jvca.2021.09.016","article-title":"Anesthetic Management of Severe Pulmonary Hypertension in Pregnancy","volume":"36","author":"Wolla","year":"2022","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s00408-011-9345-9","article-title":"Pulmonary arterial hypertension in the setting of pregnancy: A case series and standard treatment approach","volume":"190","author":"Smith","year":"2012","journal-title":"Lung"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1183\/16000617.0079-2016","article-title":"Pregnancy in pulmonary arterial hypertension","volume":"25","author":"Olsson","year":"2016","journal-title":"Eur. Respir. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"100358","DOI":"10.1016\/j.ajogmf.2021.100358","article-title":"Pregnancy and pulmonary arterial hypertension: A case series and literature review","volume":"3","author":"Yang","year":"2021","journal-title":"Am. J.Obs. Gynecol. MFM"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jpba.2015.12.006","article-title":"Determination and quantitation of sildenafil and its major metabolite in the breast milk of a lactating woman","volume":"120","author":"Wollein","year":"2016","journal-title":"J. Pharm. Biomed. Anal."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1086\/682230","article-title":"Statement on pregnancy in pulmonary hypertension from the Pulmonary Vascular Research Institute","volume":"5","author":"Hemnes","year":"2015","journal-title":"Pulm. Circ."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1055\/s-0033-1355438","article-title":"Birth control and pregnancy management in pulmonary hypertension","volume":"34","author":"Olsson","year":"2013","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1136\/bmj.38756.482882.DE","article-title":"Pregnancy and congenital heart disease","volume":"332","author":"Uebing","year":"2006","journal-title":"BMJ"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1503\/cmaj.060870","article-title":"Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term","volume":"176","author":"Liu","year":"2007","journal-title":"CMAJ"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1177\/1753465812461680","article-title":"Pulmonary arterial hypertension in pregnant women","volume":"7","author":"Safdar","year":"2013","journal-title":"Adv. Respir. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1097\/AOG.0000000000001896","article-title":"Pulmonary Hypertension in Pregnancy: A Report of 49 Cases at Four Tertiary North American Sites","volume":"129","author":"Meng","year":"2017","journal-title":"Obs. Gynecol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2547","DOI":"10.1053\/j.jvca.2018.01.043","article-title":"Perioperative Management of Pregnant Women with Idiopathic Pulmonary Arterial Hypertension: An Observational Case Series Study from China","volume":"32","author":"Zhang","year":"2018","journal-title":"J.Cardiothorac.Vasc.Anesth."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1093\/bja\/ael302","article-title":"Haemodynamic effects of oxytocin given as i.v. bolus or infusion on women undergoing Caesarean section","volume":"98","author":"Thomas","year":"2007","journal-title":"Br. J.Anaesth."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.ccl.2020.09.007","article-title":"Pulmonary Arterial Hypertension in Pregnancy","volume":"39","author":"Ballard","year":"2021","journal-title":"Cardiol. Clin."},{"key":"ref_62","first-page":"4731","article-title":"Association of hemodynamics during caesarean section, outcomes after caesarean section and hormone changes with different anesthesia in pregnant women with severe pulmonary arterial hypertension","volume":"15","author":"Wang","year":"2018","journal-title":"Exp. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.amjcard.2006.06.052","article-title":"Effects of levosimendan on right ventricular function in patients with advanced heart failure","volume":"11","author":"Parissis","year":"2006","journal-title":"Am. J.Cardiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1016\/0002-9149(87)90616-3","article-title":"Differential effects of milrinone and dobutamine on right ventricular preload, afterload and systolic performance in congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy","volume":"60","author":"Eichhorn","year":"1987","journal-title":"Am. J.Cardiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1161\/CIRCULATIONAHA.107.728840","article-title":"Inotropes and vasopressors: Review of physiology and clinical use in cardiovascular disease","volume":"118","author":"Overgaard","year":"2008","journal-title":"Circulation"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/cc2338","article-title":"Science Review: Vasopressin and the cardiovascular system part 2\u2014Clinical physiology","volume":"8","author":"Holmes","year":"2004","journal-title":"Crit. Care."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Anjum, H., and Surani, S. (2021). Pulmonary Hypertension in Pregnancy: A Review. Medicina, 57.","DOI":"10.3390\/medicina57030259"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s10741-015-9514-7","article-title":"Hospital and intensive care unit management of decompensated pulmonary hypertension and right ventricular failure","volume":"21","author":"Buch","year":"2016","journal-title":"Heart Fail. Rev."},{"key":"ref_69","first-page":"7031731","article-title":"Use of Extracorporeal Membrane Oxygenation in Postpartum Management of a Patient with Pulmonary Arterial Hypertension","volume":"2018","author":"Safdar","year":"2018","journal-title":"Case Rep.Pulmonol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2152","DOI":"10.1053\/j.jvca.2017.04.012","article-title":"Challenge of Pregnancy in Patients with Pre-Capillary Pulmonary Hypertension: Veno-Arterial Extracorporeal Membrane Oxygenation as an Innovative Support for Delivery","volume":"31","author":"Vitulo","year":"2017","journal-title":"J.Cardiothorac.Vasc.Anesth."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.ccl.2016.04.007","article-title":"Special Situations in Pulmonary Hypertension: Pregnancy and Right Ventricular Failure","volume":"34","author":"Svetlichnaya","year":"2016","journal-title":"Cardiol. Clin."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e18109","DOI":"10.1097\/MD.0000000000018109","article-title":"Bilateral lung transplantation after caesarean section in pregnancy with severe pulmonary arterial hypertension: A case report","volume":"98","author":"Ye","year":"2019","journal-title":"Medicine"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"689764","DOI":"10.3389\/fmed.2021.689764","article-title":"Favorable Pregnancy Outcomes in Women with Well-Controlled Pulmonary Arterial Hypertension","volume":"8","author":"Corbach","year":"2021","journal-title":"Front. Med."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Wojciuk, M., Dziecio\u0142-Anikiej, Z., Kaniewska, K., Cio\u0142kiewicz, M., Moskal-Jasinska, D., and Kuryliszyn-Moskal, A. (2022). Exercise Training as a Non-Pharmacological Therapy for Patients with Pulmonary Arterial Hypertension: Home-Based Rehabilitation Program and Training Recommendations. J. Clin. Med., 11.","DOI":"10.3390\/jcm11236932"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/5\/4625\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:48:41Z","timestamp":1760122121000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/5\/4625"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,6]]},"references-count":74,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["ijerph20054625"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20054625","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,6]]}}}