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在患有先天性心脏病的妇女怀孕后果
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
概括
患有先天性心脏病的孕妇面临重大风险. 心脏功能受损和肺部反增加了心脏和新生儿不良结果的可能性.
科学领域:
- 心脏病学 心脏病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 孕妇患先天性心脏病 (CHD) 会增加心脏和新生儿并发症的风险.
- 这些怀孕中不良结果的危险因素尚未完全定义.
研究的目的:
- 确定患有心脏病的孕妇中产妇心脏事件和新生儿不良后果的危险因素.
- 改善怀孕妇女患有心脏病的心脏风险评估.
主要方法:
- 在53名患有心血管疾病的妇女中,追溯对90例怀孕的随访 (1998-2004).
- 对母亲心脏事件和新生儿结果的分析.
- 使用赔率比率 (OR) 识别单变量和独立预测因素.
主要成果:
- 孕妇心脏事件发生在19.4%的怀孕中;肺水腫 (16.7%) 和心律失常 (2.8%) 是最常见的.
- 母亲心脏事件的独立预测因素包括肺下心室喷射率降低/严重的肺吐 (OR,9.0) 和吸烟史 (OR,27.2).
- 新生儿不良后果发生在27.8%,包括早产 (20.8%) 和较小的妊娠年龄 (8.3%). 下心室外流通道梯度>30 mm Hg预测了不良的新生儿结果 (OR,7.5).
结论:
- 在患有心脏病的孕妇中,孕妇的心脏和新生儿并发症的发生率很高.
- 肺下心室缩功能受损和/或严重的肺吐是造成母亲心脏不良后果的关键风险因素.
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