肺高血压的严重程度和分类如何影响怀孕结果:系统性审查和时间表
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
International journal of obstetric anesthesia
|May 23, 2024
概括
患有肺高血压 (PH) 的妇女的怀孕结果随着时间的推移而有所改善. 孕产妇死亡率显著下降,但风险因PH严重程度而异,需要谨慎的预孕咨询.
科学领域:
- 心脏病学 心脏病学
- 产科和妇科 产科和妇科
- 肺部病理学 肺部病理学
背景情况:
- 肺高血压 (PH) 对孕妇构成重大风险,死亡率历史高.
- 最近的文献表明,孕期PH患者的孕产妇结果可能有所改善.
- 了解疾病严重程度对于管理与怀孕相关的风险至关重要.
研究的目的:
- 系统地审查孕妇PH的孕妇的孕产妇结果和存活率.
- 分析随着时间的推移,产妇死亡率的趋势.
- 评估PH疾病严重程度对妊娠结果的影响.
主要方法:
- 从1967年到2021年,对66篇出版物的系统审查,选了9097项潜在研究.
- 专注于PH妇女的孕产妇存活率和疾病严重程度.
- 根据出版日期和特定的PH分类分析了死亡率.
主要成果:
- 随着时间的推移,PH患者的孕产妇死亡率下降,从2015年之前的11.6%降至2015年后的8.2%.
- 根据疾病严重程度,死亡率有很大差异:轻度PH为0.8%,异常性肺动脉高血压为7.4-24.0%,艾森门格综合征为26.2%.
- 发现的一个局限性是,在没有当代参数的情况下,使用心声回声学估计的压力来评估严重程度.
结论:
- 肺高血压中母亲的结果显示持续改善.
- 疾病严重程度是PH妇女怀孕相关风险的关键决定因素.
- 目前的PH分类和严重性评估方法可能需要改进,以准确地评估预孕风险.
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