Studies have shown that PPH during pregnancy can produce birth defects, lung problems, and a multiple host of conditions for the newborn. In addition, PPH during pregnancy carries a high maternal mortality rate.
If a women took Fen-Phen as a weight loss suppressant, the chances of her acquiring PPH is a given. Moreover, if this same woman became pregnant, the risk to her health is even greater.
Primary pulmonary hypertension is a rare, progressive condition aggravated by the physiologic changes occurring during pregnancy and surgery. The maternal mortality rate associated with pregnancy and PPH ranges from 30 to 50%.
To preface the extent to which PPH during pregnancy can cause a host of health problems, particularly for the mother to be, here is a case study of a woman in her 30’s who had PPH during pregnancy.
A 35-year-old patient with a history of hypothyroidism presented at 26 weeks, gestation with progressive exertional dyspnea and fatigue of several weeks duration. She also reported several recent syncopal episodes. Her first pregnancy was uncomplicated, and she denied prior cardiopulmonary disease, illicit drug use, or ingestion of anorexigens.
On physical examination, her vital signs were normal. However, the jugular venous distension was present (which is one of the symptoms of PPH). An echocardiogram displayed a dilated right ventricle, paradoxical septal wall motion, and normal left ventricular wall motion.
The patient was admitted to labor and delivery, and was prescribed bed rest, oxygen, diuretics, and heparin. The progression of labor was inadequate, and a cesarean section was scheduled. A bilateral tubal ligation was performed with patient consent.
Three weeks later, the patient underwent a vasodilator trial with calcium-channel blockers but did not have a favorable response; hence, she was continued on epoprostenol therapy. Presently, she has resumed an active lifestyle as a housewife and mother. Furthermore, her 2-year-old son is in good health without any developmental delays.
As a result of the maternal-fetal mortality rate that still exists, PPH specialists have concluded that contraception and early fetal termination must be considered. They observe that the maternal mortality rate is caused by the increased demands on the heart during pregnancy.
In addition, other changes include an increase in cardiac output during labor in patients receiving local anesthesia. These events place a great demand on the cardiovascular system, with the greatest incidence of mortality occurring during the first several post-operative days. Subsequently, several reports have described the use of vasodilator therapy with good outcomes.
Several factors have been implicated as potential risk factors for maternal death, including mode of delivery, type and technique of anesthesia, and manner of maternal monitoring. An important component in the successful management of PPH during pregnancy involves a team approach with an obstetrician, PPH specialist, cardiology specialist, anesthesiologist, and experienced nursing staff.
PPH during pregnancy is likely to worsen during labor and delivery, resulting in a high maternal mortality rate. Elective cesarean section may have to be performed. Moreover, there are no physical deformities or fetal growth retardation. The management of patients with PPH during pregnancy is of great importance for a successful maternal-fetal outcome.
What does this all mean? In the case of the 35 year old woman, she was lucky. She had PPH specialists and other qualified doctors who recognized the signs, treated her appropriately, delivered the baby via caesarean section, and put the woman on a proper drug regimen.
However, after reading her history, it is clear that she took Fen-Phen as a weight loss suppressant and developed PPH during pregnancy. The question then becomes, does this woman have legal recourse? Most assuredly, she does. Since Fen-Phen was taken off the shelves in 1997, law suits have been on the upswing. This is because there is a 10 year delay from the time one takes Fen-Phen to the time symptoms appear.
Unfortunately, in this woman’s case, her pregnancy only complicated the matter further. She had every right in the world to contact her PPH attorney and file action against the company who produced Fen-Phen.
Fortunately, her baby did not suffer any ill effects; however, the maternal-fetal mortality rate did put her at an even higher risk. This is unacceptable for any woman about to give birth. The stress and strain is immeasurable as evidenced by the symptoms which ultimately caused the woman to need intervention.
It is imperative that women be made aware of the dangers associated with prior usage of Fen-Phen, and to abstain from taking any form of anti-depressant when pregnant. The risk of developing PPH during pregnancy is too high.