<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1726-6718</journal-id>
<journal-title><![CDATA[Revista Cubana de Anestesiología y Reanimación]]></journal-title>
<abbrev-journal-title><![CDATA[Rev cuba anestesiol reanim]]></abbrev-journal-title>
<issn>1726-6718</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1726-67182021000100009</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Conducción anestésica perioperatoria en gestante a término con hipertensión pulmonar idiopática]]></article-title>
<article-title xml:lang="en"><![CDATA[Perioperative anesthetic management in term pregnant women with idiopathic pulmonary hypertension]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dávila Cabrera]]></surname>
<given-names><![CDATA[Sergio Felipe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Clavel]]></surname>
<given-names><![CDATA[Luis Leonel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández Román]]></surname>
<given-names><![CDATA[Marvin Alexis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guerra Rosabal]]></surname>
<given-names><![CDATA[Leonor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Montenegro Valhuerdi]]></surname>
<given-names><![CDATA[Ariadna]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Cardiología y Cirugía Cardiovascular  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Clínico Quirúrgico &#8220;Salvador Allende&#8221;  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Pediátrico &#8220;Juan Manuel Márquez&#8221;  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<volume>20</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1726-67182021000100009&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1726-67182021000100009&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1726-67182021000100009&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La hipertensión arterial pulmonar es una enfermedad con una baja incidencia en la gestante, aunque trae consigo una alta mortalidad una vez presentada. Un diagnóstico oportuno y un manejo perioperatorio adecuado minimizan el riesgo de desenlace fatal tanto para la madre como el feto.  Objetivo:  Describir el comportamiento de la hipertensión arterial pulmonar en la gestante a término y su conducción anestésica.  Presentación del caso:  Paciente de 23 años, antecedentes de salud, edad gestacional de 35.2 semanas. Luego de presentar dolor de espalda y ardor en el pecho relacionado con el esfuerzo, palpitaciones, disnea y bloqueo de rama derecha en electrocardiograma, se ingresa en UTI con sospecha de tromboembolismo pulmonar, el cual queda descartado tras diagnóstico confirmatorio de hipertensión pulmonar después de realizar angio TAC y ecocardiografía. Se decide realizar cesárea programada bajo técnica regional peridural, sin complicaciones tanto para la madre como el niño. Después de 2 días bajo vigilancia intensiva se traslada a su centro hospitalario de cabecera.  Conclusiones:  La vía del parto, así como una elección adecuada de la técnica anestésica, puede ser la diferencia entre el éxito y la fatalidad. Las técnicas regionales suelen recomendarse por encima de la técnica de anestesia general siempre que no se presenten contraindicaciones.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Pulmonary arterial hypertension is a disease with low incidence in the pregnant woman, although it brings about high mortality once presented. Timely diagnosis and adequate perioeprative management minimize the risk of fatal outcome for both mother and fetus.  Objective:  To describe pulmonary arterial hypertension and its anesthetic management in the term pregnant woman.  Case presentation:  23-year-old female patient, with health history and gestational age of 35.2 weeks. After presenting back pain and chest burning associated with exertion, palpitations, dyspnea and right bundle branch block in the electrocardiogram, the patient was admitted to the intensive care unit with suspected pulmonary thromboembolism, which was ruled out due to the confirmatory diagnosis of pulmonary hypertension after performing computerized tomography angiography and echocardiography. Scheduled cesarean section was decided to be perform using the regional peridural technique, without complications for both the mother and the child. After two days under intensive surveillance, she was transferred to her primary hospital.  Conclusions:  The route of delivery, as well as an adequate choice of the anesthetic technique, can be the difference between success and fatality. Regional techniques are usually recommended over the general anesthesia technique, as long as there are no contraindications.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[hipertensión arterial pulmonar idiopática]]></kwd>
<kwd lng="es"><![CDATA[gestante]]></kwd>
<kwd lng="es"><![CDATA[ecocardiografía]]></kwd>
<kwd lng="es"><![CDATA[técnica anestésica]]></kwd>
<kwd lng="en"><![CDATA[idiopathic pulmonary arterial hypertension]]></kwd>
<kwd lng="en"><![CDATA[pregnant woman]]></kwd>
<kwd lng="en"><![CDATA[echocardiography]]></kwd>
<kwd lng="en"><![CDATA[anesthetic technique]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Garabedian]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hansen]]></surname>
<given-names><![CDATA[WF]]></given-names>
</name>
<name>
<surname><![CDATA[Gianferrari]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epo-prostenol treatment for idiopathic pulmonary arterial hypertension in pregnancy]]></article-title>
<source><![CDATA[J Perinatol]]></source>
<year>2010</year>
<volume>30</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>628-31</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Regitz-Zagrosek]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Roos-Hesselink]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
<name>
<surname><![CDATA[Bauersachs]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ESC guidelines for the management of cardiovascular diseases during pregnancy]]></article-title>
<collab>Scientific Document Group</collab>
<source><![CDATA[Eur Heart J]]></source>
<year>2018</year>
<volume>39</volume>
<numero>34</numero>
<issue>34</issue>
<page-range>3165-241</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Weiss]]></surname>
<given-names><![CDATA[BM]]></given-names>
</name>
<name>
<surname><![CDATA[Zemp]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Seifert]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Hess]]></surname>
<given-names><![CDATA[OM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Outcome of pulmonary vascular disease in pregnancy A systematic overview from 1978 through 1996]]></article-title>
<source><![CDATA[J Am CollCardiol]]></source>
<year>1998</year>
<volume>31</volume>
<page-range>1650-7</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[TT]]></given-names>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors and risk index of cardiac events in pregnant women with heart disease]]></article-title>
<source><![CDATA[Chin Med J (Engl)]]></source>
<year>2012</year>
<volume>125</volume>
<page-range>3410-5</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Khan]]></surname>
<given-names><![CDATA[Javed]]></given-names>
</name>
<name>
<surname><![CDATA[Majdy]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Idrees, saudi guidelines on the diagnosis and treatment of pulmonary hypertension: pregnancy in pulmonary hypertension]]></article-title>
<source><![CDATA[Annals of Thoracic Medicine]]></source>
<year>2014</year>
<volume>9</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Simonneau]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Haemodynamic definitions and updated clinical classification of pulmonary hypertension]]></article-title>
<source><![CDATA[Eur Respir J]]></source>
<year>2019</year>
<volume>53</volume>
<page-range>1801913</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Anthony]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Sliwa]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Decompensated heart failure in pregnancy]]></article-title>
<source><![CDATA[Card Fail Rev]]></source>
<year>2016</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>20-6</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silversides]]></surname>
<given-names><![CDATA[CK]]></given-names>
</name>
<name>
<surname><![CDATA[Grewal]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Mason]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pregnancy outcomes in women with heart disease: the CARPREG II Study]]></article-title>
<source><![CDATA[J Am Coll Cardiol]]></source>
<year>2018</year>
<volume>71</volume>
<numero>21</numero>
<issue>21</issue>
<page-range>2419-30</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Siu]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prospective multicenter study of pregnancy outcomes in women with heart disease]]></article-title>
<source><![CDATA[Circulation]]></source>
<year>2001</year>
<volume>104</volume>
<page-range>515-21</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruys]]></surname>
<given-names><![CDATA[TP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Heart failure in pregnant women with cardiac disease Data from the ropac]]></article-title>
<source><![CDATA[Heart]]></source>
<year>2014</year>
<volume>100</volume>
<page-range>231-8</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Drenthen]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictors of pregnancy complications in women with congenital heart disease]]></article-title>
<source><![CDATA[Eur Heart J]]></source>
<year>2010</year>
<volume>31</volume>
<page-range>2124-32</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Kellerhals]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Horton]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Fisher]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Krishna]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Badell]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary Arterial Hypertension in Pregnancy: Outline of Multidisciplinary Care]]></article-title>
<source><![CDATA[Cur Op Gyn Obs]]></source>
<year>2019</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>346-53</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kiely]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
<name>
<surname><![CDATA[Condliffe]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Wilson]]></surname>
<given-names><![CDATA[VJ]]></given-names>
</name>
<name>
<surname><![CDATA[Gandhi]]></surname>
<given-names><![CDATA[SV]]></given-names>
</name>
<name>
<surname><![CDATA[Elliot]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pregnancy and pulmonary hypertension: a practical approach to management]]></article-title>
<source><![CDATA[Obstet Med]]></source>
<year>2013</year>
<volume>6</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>144-54</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kayle]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Nihar]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Robert]]></surname>
<given-names><![CDATA[WE]]></given-names>
</name>
<name>
<surname><![CDATA[Heather]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Josephine]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Erica]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardio-obstetrics: Recognizing and managing cardiovascular complications of pregnancy]]></article-title>
<source><![CDATA[Cleveland clinic journal of medicine]]></source>
<year>2020</year>
<volume>87</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McGlothlin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ivascu]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Heerdt]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anesthesia and pulmonary hypertension]]></article-title>
<source><![CDATA[Prog Cardiovasc Dis]]></source>
<year>2012</year>
<volume>55</volume>
<page-range>199-217</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Lu]]></surname>
<given-names><![CDATA[JK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anesthetic management in pregnant patients with severe idiopathic pulmonary arterial hypertension]]></article-title>
<source><![CDATA[International Journal of Obstetric Anesthesia]]></source>
<year>2014</year>
<volume>23</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>289-90</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Viktorsdottir]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary hypertension in pregnancy and anesthetic implications]]></article-title>
<source><![CDATA[Current Anesthesiology Reports]]></source>
<year>2015</year>
<volume>5</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>82-90</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mostert]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An approach to the pregnant patient with pulmonary hypertension]]></article-title>
<source><![CDATA[Southern African Journal of Anaesthesia and Analgesia]]></source>
<year>2018</year>
<volume>24</volume>
<numero>3^s1</numero>
<issue>3^s1</issue>
<supplement>1</supplement>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Maxwell]]></surname>
<given-names><![CDATA[BG]]></given-names>
</name>
<name>
<surname><![CDATA[Pearl]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Kudelko]]></surname>
<given-names><![CDATA[KT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Case 7-2012. Airway management and perioperative decision making in the patient with severe pulmonary hypertension who requires emergency noncardiac surgery]]></article-title>
<source><![CDATA[J Cardiothorac Vasc Anesth]]></source>
<year>2012</year>
<volume>26</volume>
<page-range>940-4</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Susan]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
<name>
<surname><![CDATA[Christopher]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Richard]]></surname>
<given-names><![CDATA[NC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary hypertension and right ventricular failure in emergency medicine]]></article-title>
<source><![CDATA[Annals of Emergency Medicine]]></source>
<year>2015</year>
</nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bhavna]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Kamna]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Lalit]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Anish]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anesthetic considerations for a parturient with pulmonary hypertension]]></article-title>
<source><![CDATA[The Indian Anaesthetists' Forum]]></source>
<year>2017</year>
<volume>18</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
