Reactions 1792, p97 - 22 Feb 2020 1

Epoprostenol S

Preterm delivery and lethargy following exposure during pregnancy: case report
A 31-year-old woman experienced extreme lethargy and had preterm delivery following treatment with epoprostenol for
pulmonary arterial hypertension (PAH).
The pregnant woman (G13P1A11), presented to the clinic with dyspnoea, and was subsequently diagnosed with PAH. She then
started receiving IV epoprostenol at 27 weeks and 5 days gestation. Her initial epoprostenol dose was 2 ng/kg/min with scheduled
increments of 1–2 ng/kg/min every 15 minutes until occurence of any side efefcts. However, she developed extreme lethargy.
However, the woman’s epoprostenol therapy was stopped. Lethargy continued and subsequently she was transferred for a higher
level of care. After her arrival and prior to the re-initiation of epoprostenol, fetal heart tracing showed decelerations. Therefore, an
emergent caesarean delivery was performed at 28 weeks of gestation. The neonate was delivered and transferred to newborn ICU.
Postpartum, she received second course epoprostenol and was discharged on sildenafil and macitentan. However, ECG did not
demonstrate improvement or worsening of PAH.
Davtyan E, et al. Management of severe pulmonary hypertension in pregnancy with epoprostenol. Journal of Investigative Medicine 68 (Suppl. 1): A62 abstr. 144, Jan 2020.
Available from: URL: https://jim.bmj.com/content/jim/68/1/91.full.pdf [abstract] 803456154

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