I recently saw a patient in her 30s with pulmonary hypertension. This condition was a result of a congenital malformation, which was not previously diagnosed. This woman led a normal life, was athletic, and had a job and two children.

A few years ago, she suffered a major stroke because the pressure in her lungs was continuing to rise, threatening her cardiac function, and finally releasing a blood clot that caused the stroke. Miraculously, she survived the stroke, with full neurologic function. She was diagnosed with the condition (finally) and was placed on medications and under the care of cardiologists.

Because her health was now forever endangered, this woman got an IUD to prevent another pregnancy, which could potentially kill her. But despite this very reliable form of contraception, her IUD moved, and she conceived. Her pregnancy was discovered during her routine cardiology visits.

This woman had two kids, had just gotten engaged, and was planning her wedding and the rest of her life, which was suddenly threatened. Every week of the ongoing pregnancy threatened her life with increased morbidity and mortality from worsening of her condition, and this decision was hard for her to make. But she knew she wanted to be alive for her kids and her future husband, and she chose to terminate the pregnancy.