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This clinical description of pregnancy follow-up and labour management in women with severe pulmonary hypertension caused by an interventricular septum defect is intended to familiarize practicing physicians with the methods for maintaining pregnancy and ensuring spontaneous delivery despite the said pathology. Indispensable conditions for the attainment of these goals include thorough clinical and laboratory control, comprehensive analysis of possible complications, efficacious epidural anesthesia, and correct choice of medicines.

A study of 96 patients (23 controls, 57 patients with arterial hypertension and 16 with aortal stenosis) has shown the ascending aortal pressure curve to conform to the ascending exponent with different time constants in all cases. The expulsion time constant for middle age (44 +/- 4 years) was 0.063 +/- 0.002 s, with the expulsion time/time constant ratio of 4.01, in normal controls; 0.095 +/- 0.03 s and 2.6, respectively, in hypertensive patients; and 0.170 s and 1.72, respectively, in patients with aortal stenosis. The difference between ventriculographic and estimated left ventricular stroke volumes was not significant (p less than 0.001). Hemodynamic resistance to expulsion was 132 +/- 6 din X s X cm-5 in the controls, and 299 +/- 14 and 305 +/- 28 din X s X cm-5, respectively, in patients with arterial hypertension and aortal stenosis.