FATAL OUTCOME OF PREGNANCY IN THE EISENMENGER-SYNDROME

A mildly symptomatic 28-year-old woman with Eisenmenger syndrome bt ca me pregnant against advice, and presented at 17 weeks insisting on con tinuing the pregnancy. She underwent an emergency Caesarean section fu r pre-eclampsia at 26 weeks, delivering a live 620 g boy, who survived to leave the hospital. In the post-partum period, she presented incre asing hypoxemia, despite treatment with noradrenaline, nitric oxide an d prostacyclin. She died 2 weeks after delivery from pulmonary haemorr hage. Necropsy showed histological signs of severe pulmonary vascular disease, with evidence of diffuse fibrinoid necrosis, vasculitis and h aemorrhage.