在怀孕期间进行心脏手术是否安全? 一个40年的单一机构经验
Katlin T Schmitz1, Elizabeth H Stephens2, Joseph A Dearani2
1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
The Annals of thoracic surgery
|August 8, 2024
概括
怀孕期间使用心肺旁路进行心脏手术的产妇死亡率低,胎儿死亡率高. 考虑在可活胎儿手术前进行剖腹产,以减少胎儿损失.
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
- 心血管外科心血管外科
背景情况:
- 对于接受心肺旁路心脏手术的孕妇,对孕妇和胎儿的结果存在有限的数据.
- 描述这些结果对于优化患者护理和手术决策至关重要.
研究的目的:
- 用心肺旁路术进行心脏手术的孕妇患者的孕产妇和胎儿结局的特征.
- 评估妊娠年龄和手术时间对结果的影响.
主要方法:
- 从1978年到2023年进行心肺旁路心脏手术的孕妇患者的回顾性评估.
- 描述性统计分析,包括连续变量的中位数和二分类变量的发生率.
主要成果:
- 29名孕妇接受了心脏手术,平均怀孕时间为25周.
- 孕产妇死亡率很低 (3%),但胎儿损失很大 (总体为17%).
- 在手术期间继续怀孕时,胎儿死亡率较高 (29%),而在手术前分娩 (14%).
结论:
- 怀孕期间的心脏手术与较低的孕产妇死亡率相关,但胎儿死亡率显著.
- 在心肺旁路术之前的剖腹产可能会在可行的怀孕中将胎儿死亡率降到最低.
- 这一单一机构系列支持一种策略,即在心脏手术之前考虑早产.
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