Evidence map›Paper›PMID 40816823›Full record

ArticleJACC. Case reports2025

Successful Vaginal Birth in Severe Idiopathic Pulmonary Arterial Hypertension: Lessons Learned From a Cardio-Obstetric Challenge.

Ashley Hesson, Meghan Horn, Allison Janda, Lauren Holroyd, Michael Taylor, Anna Dubovoy, Damon Wallace, Susanne McDevitt, Melinda Davis, Elizabeth Langen

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ashley HessonDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA; Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Meghan HornDepartment of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA.
Allison JandaDepartment of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA.
Lauren HolroydDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.
Michael TaylorDepartment of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA.
Anna DubovoyDepartment of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA.
Damon WallaceDepartment of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA.
Susanne McDevittSchool of Nursing, University of Michigan, Ann Arbor, Michigan, USA.
Melinda DavisDivision of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Elizabeth LangenDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: elangen@med.umich.edu.

Funding

PHEnylephrine versus NOrepinephrine in Major NONcardiac surgery (PHENOMeNON): Foundational Studies for a Pragmatic Randomized Clinical Trial.K23HL166685 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Allison Mary Janda · 2023 to 2026
$689k
NHLBI NIH HHS K23 HL166685
6 · The paper itself

Abstract

backgroundSevere idiopathic pulmonary arterial hypertension (si-PAH) carries high maternal mortality risk. The majority of births are via cesarean. Multidisciplinary delivery planning is essential to optimize outcomes. CASE SUMMARY: A 33-year-old nulliparous woman presented with desired pregnancy and functional class IIB si-PAH despite preconception counseling. The multispecialty cardio-obstetrics team offered a highly coordinated attempt at vaginal birth consistent with the patient's strong preference, acknowledging either birth modality carried substantive risks. Induction of labor proceeded without complication until the second stage, at which time a pulmonary arterial hypertension crisis ensued. Emergent midpelvic forceps-assisted birth was performed. Maternal status stabilized after delivery. DISCUSSION: Most patients with si-PAH undergo cesarean delivery to facilitate resource coordination and hemodynamic control. We present key safety considerations and challenges for vaginal birth specific to si-PAH. TAKE-HOME MESSAGE: Attempted vaginal birth in si-PAH can be achieved in institutions with appropriate resources.

Indexed as

anesthesiapregnancypulmonary hypertension

Identifiers

PMID40816823
PMCPMC12461886

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.