4种不同病因导致的54例妊娠期心力衰竭与妊娠结局的分析  

Analysis on outcomes of heart failure during pregnancy and pregnant outcomes in 54 cases induced by 4 kinds of causes

作　　者：杨洁[1] 余琳[1] 侯棚钟[1] 刘贞[1] 陈敦金[1] 

机构地区：[1]广州医学院第三附属医院妇产科广州市重症孕产妇救治中心,510150

出　　处：《中国妇幼保健》2010年第30期4357-4359,共3页Maternal and Child Health Care of China

摘　　要：目的:了解妊娠合并心衰对母儿的危害,探讨妊娠合并心衰四种不同发病原因与妊娠结局的关系。方法:回顾性分析2004年12月～2007年9月广州市重症孕产妇救治中心收治的54例妊娠期心力衰竭患者,对其发病原因及妊娠结局进行分析。结果:妊娠期高血压疾病性心脏病发生心衰者34例(62.96%),妊娠合并风湿性心脏病8例(14.81%),围产期心肌病7例(12.96%),妊娠合并甲亢性心脏病5例(9.25%)。其终止妊娠的时间分别是(33.26±2.66)周、(32.46±5.97)周、(37.22±4.88)周、(36.34±4.67)周。孕产妇死亡2例(3.70%),新生儿死亡9例(16.66%)。结论:妊娠合并心力衰竭的病因中以妊娠期高血压疾病最为常见;妊娠合并风湿性心脏病的产妇以及胎儿的预后最差,早产率高;围生期心肌病以及甲亢性心脏病如果控制及时,新生儿的预后较好。所以明确妊娠合并心力衰竭的原因,对及时正确处理妊娠合并心力衰竭,有利于降低围产期孕产妇和围产儿的死亡率。Objective：To understand the dangers of heart failure during pregnancy to mothers and neonates,explore the relationship between 4 kinds of causes and pregnant outcomes in cases with heart failure during pregnancy.Methods：54 cases with heart failure during pregnancy from November 2004 to September 2007 were analyzed retrospectively,the causes and pregnant outcomes were analyzed.Results：The incidences of heart failure induced by hypertensive disorder complicating pregnancy（HDCP）,rheumatic heart disease,peripartum cardiomyopathy,hyperthyroid heart disease combined with pregnancy were 62.96%（34 cases）,14.81%（8 cases）,12.96%（7 cases） and 9.25%（5 cases）,respectively,and the average terminal times of pregnancy were（33.26±2.66） weeks,（32.46±5.97） weeks,（37.22±4.88） weeks and（36.34±4.67） weeks,respectively;the numbers of maternal death and neonatal death were 2 cases（3.70%） and 9 cases（16.66%）,respectively.Conclusion：The main cause of heart failure during pregnancy is HDCP;the prognosis of mothers and neonates in pregnant women with rheumatic heart disease is the worst,and their premature birth rate is the highest;the prognosis of neonates is good based on timely control of peripartum cardiomyopathy and hyperthyroid heart disease;clear causes and correct treatment of heart failure during pregnancy are helpful to reduce the maternal and perinatal mortality.

关 键 词：妊娠合并症 心力衰竭 产科结局 围生结局 

分 类 号：R714.25[医药卫生—妇产科学]