患有最高心血管风险的妇女的妊娠结果 (mWHO类IV):一个单中心研究
Heba Nashat1, Abigail Masding2, Kaushiga Krishnathasan1
1Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, United Kingdom; Heart and Lung Institute, Imperial College London, United Kingdom.
International journal of cardiology
|August 14, 2025
概括
世界卫生组织 (mWHO) 修改的第四类心血管疾病的妇女怀孕是高风险的,但可以通过专业护理实现. 结果显示显著的发病率,强调了早期咨询和长期监测的必要性.
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
- 产科 产科 产科 产科 产科
背景情况:
- 经过修改的世界卫生组织 (mWHO) 分类对孕产妇心血管疾病风险进行了分层.
- 由于高发病率和死亡率风险,怀孕在mWHO Class IV中通常是禁忌的.
- 专业的多学科护理可以在选择的高风险怀孕中实现成功的结果.
研究的目的:
- 为了检查患有mWHO第四类心血管疾病的妇女的怀孕结果.
- 为了评估母亲和新生儿并发症和长期随访在这个高风险队列.
主要方法:
- 对30名女性的32次怀孕进行了回顾性队列研究,这些妇女被分类为mWHO Class IV (2008-2022).
- 收集的数据包括母亲人口统计,心脏/产科并发症,分娩细节,新生儿结果和长期随访.
- 分析的重点是孕产妇和新生儿的发病率和死亡率.
主要成果:
- 母亲平均年龄为29.6岁;流行病包括肺动脉高血压 (PAH) 和心室功能障碍.
- 心血管事件发生在65.6%的怀孕中,主要与PAH相关.
- 观察到高比例的剖腹产 (100%),早产 (75%) 和新生儿重症监护室入院 (87%).
- 产后死亡率发生在4名妇女中 (1名产后晚期,3名长期);1年的MACE率为9.3%.
结论:
- 怀孕在mWHO第四类疾病带有相当大的风险,但有利的结果是可能的专业怀孕心脏团队的护理.
- 高度的孕产妇发病率需要早期咨询,密切监测和全面的长期随访.
- 第三级中心管理可以改善结果,但风险仍然很大.
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