Inhaled nitric oxide for primary pulmonary hypertension in pregnancy

BACKGROUND: Primary pulmonary hypertension is a rare and dangerous entity i n pregnancy. Previous studies have found a 35-50% maternal mortality rate i n the peripartum period. To date, most reports have described treatment of these patients with diuretics, digoxin, and calcium-channel blockers. CASE: We describe the successful treatment of a primigravida with severe pr imary pulmonary hypertension. We used elective intubation before labor, inh aled nitric oxide therapy, and assisted vaginal delivery with epidural anes thesia that resulted in a viable infant and survival of the mother. CONCLUSION. Nitric oxide can be used to successfully treat primary pulmonar y hypertension in pregnancy. (Obstet Gynecol 2001;98:895-8. (C) 2001 by the American College of Obstetricians and Gynecologists.).