The mortality post c- section in patient with pulmonary hypertension is higher than in postpartum vaginal delivery with epidural.
Decision depends on severity of PH, obstetric situation and general parturient condition. There are two choices for anesthesia( if CS): epidural careful top up v.s. general anesthesia. Spinal single shot anesthesia is contraindicated in PH.
Thank you Kestutis Rimaitis for your answer, but my question is you advice your patient for normal vaginal delivery or elective cesarean section?
For labor we are using analgesia not anesthesia , so I thought about C.S. Vaginal delivery - is priority in most clinical conditions and comorbidities. But in severe PH - mortality rate is quite high even in very high perinatal care level countries. Severe PH actually is rare, but medical contraindication for pregnancy, so for labor also.
Please look at my paper "Cesarean delivery in severe pulmonary hypertension: A case report" and you will find more motivated answers
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