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生まれながらの心臓病の女性における妊娠の結果
Paul Khairy1, David W Ouyang, Susan M Fernandes
1Boston Adult Congenital Heart Service, Brigham and Women's Hospital, Boston, MA, USA. paul.khairy@cardio.CHBoston.org
Circulation
|February 2, 2006
まとめ
生まれながらの心臓病を患っている妊婦は,重大なリスクに直面します. 心臓の機能障害と肺の再発は,有害な心臓および新生児のアウトカムの可能性を高めます.
科学分野:
- 心臓病学 心臓病学
- 妊産婦・胎児医学について
- 生まれながらの心臓病 生まれながらの心臓病
背景:
- 妊婦における先天性心疾患 (CHD) は,心臓および新生児合併症のリスクを高めます.
- これらの妊娠における有害な結果の危険因子は完全に定義されていません.
研究 の 目的:
- CHDの妊婦における母性心疾患の危険因子と新生児における有害なアウトカムを特定する.
- CHDの妊婦の心臓リスク評価を改善する.
主な方法:
- 心臓病の女性53人の90人の妊娠を遡及的に追跡した (1998年~2004年).
- 母親の心臓病および新生児のアウトカムに関する分析.
- 確率比 (OR) を用いた単変数および独立した予測者の識別.
主要な成果:
- 妊婦の心臓発作は,妊娠の19.4%で発生し,肺腫 (16.7%) と心律乱 (2.8%) が最も一般的であった.
- 母親の心臓発作の独立予測要因には,肺下室内射出分数減少/重度の肺吐 (OR,9.0) と喫煙歴 (OR, 27.2) が含まれていた.
- 新生児の不良結末は,早産 (20.8%) を含む27.8%で発生し,妊娠年齢に対して小さい (8.3%) であった. 副大動脈室外流出管の梯度が30mmHg以上であった場合,新生児への不良結果が予測された (OR,7.5).
結論:
- 母親の心臓および新生児の合併症率は,CHDの妊婦ではかなり高い.
- 肺下室内静脈機能の障害および/または重度の肺吐は,母親の不良心疾患の主要なリスク因子です.
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