Management of preeclampsia after heart transplant

Emily R. Malling, University of Iowa Carver College of Medicine, Iowa City, Iowa
Heather Anaya, University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Iowa City, Iowa
R. Erik Edens, University of Iowa Hospitals and Clinics, Department of Pediatrics, Iowa City, Iowa


We present a 20-year-old primiparous patient status post heart transplant at 6 months with long-standing hypertension progressing to super-imposed preeclampsia. Pregnancy and delivery after thoracic transplantation is no longer a rare occurrence, however, these women are at a greater risk of gestational hypertension and preeclampsia. Current literature does not provide treatment guidelines for treatment of hypertensive disorders in patients with a transplanted heart. In this case report, we explore the different treatments for maintaining blood pressures in the transplanted neurovascular system, effects of eclampsia prevention on blood pressure, and how fluctuations in blood pressure in a long-standing hypertensive can affect fetal heart tracings. A literature search was conducted using terms “solid organ transplant and preeclampsia”, “Anti-hypertensive drugs post heart transplant”, and “hypertension after heart transplantation”. No reviews on treatment of preeclampsia in cardiac transplant recipients were evident.