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完善当前风险分层指导方针 孕妇与Fontan循环:从PROFAT注册表的教训
Magalie Ladouceur1, Andrea Girnius2, Dominica Zentner3
1Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland. Department of Cardiology, Adult congenital heart disease unit, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
European journal of preventive cardiology
|July 22, 2025
概括
患有Fontan循环的妇女怀孕是高风险的,具有显著的孕产妇心血管和胎儿并发症. 目前的风险评分不足以预测这些怀孕的结果.
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:
- 怀孕在Fontan循环的妇女呈现高风险.
- 关于怀孕结果和风险分层的现有证据有限,需要仔细的咨询.
研究的目的:
- 用Fontan循环识别怀孕中的孕产妇和胎儿并发症.
- 评估现有的风险分层工具 (修改后的WHO,CARPREG II,ZAHARA) 的性能.
主要方法:
- 来自13个国际中心 (2006-2018) 的84名Fontan循环妇女108次怀孕的回顾性分析.
- 单变量和多变量分析以确定并发症预测因子.
- 评估风险分层工具的性能.
主要成果:
- 母亲心血管并发症发生在30%的怀孕中 (例如,Fontan循环衰竭17%).
- 新生儿并发症包括68%的早产;胎儿/新生儿死亡率为13%.
- 较低的怀孕前氧和预测了母亲的不良结果 (aOR 0.77). 风险模型显示差异差别,除了修改WHO的胎儿结果.
结论:
- 怀孕的妇女与Fontan循环带有相当大的孕产妇心血管和胎儿风险.
- 目前的风险分层模型缺乏对这一群体的歧视能力.
- 需要进行大规模的研究,以改善Fontan怀孕的风险预测.
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