妊娠合并心脏病伴肺动脉高压患者妊娠结局分析  

Perenatal management and pregnancy outcome in pregnant women with pulmonary hypertension complicating cardiac disease

作　　者：杨冬[1,2] 刘陶[1,2] 李蕾[1,2] 王慧[1,2] 李斌[1,2] 

机构地区：[1]首都医科大学附属安贞医院 [2]北京市心肺血管疾病研究所妇产科,北京100029

出　　处：《心肺血管病杂志》2012年第4期437-439,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨妊娠合并心脏病伴肺动脉高压患者的妊娠结局。方法:2005年6月至2010年6月我院收治44例妊娠合并心脏病伴肺动脉高压患者,根据肺动脉压力分为轻度组20例,中度组7例,重度组17例,分析各组心功能级别、终止妊娠方式及母儿结局。结果:①轻度组心功能Ⅰ～Ⅱ级15例,中度组心功能Ⅲ～Ⅳ级5例,重度组心功能Ⅲ～Ⅳ级15例。②轻度组足月产11例,新生儿平均体质量(2 929±575)g,早产5例;中度组足月产1例,早产3例;重度组足月产2例,早产10例。2例极低体质量早产儿院外死亡。③28例以剖宫产终止妊娠。④孕产妇病死率为7%,医源性流产率为27%。结论:随着肺动脉压力升高,心功能Ⅲ～Ⅳ级的发生率随之增加,早产及小于胎龄儿发生率明显增加;剖宫产是适宜的分娩方式。Objective：To evaluate the pregnancy outcome of women with pulmonary hypertension com- plicating cardiac disease. Methods： Clinical data of 44 cases of pregnant women with pulmonary hypertension from June 2005 to June 2010, were analyzed and they were divided into three groups ： 20 cases of slight group, 7 cases of moderate group and 17 cases of severe group. The cardiac functional status（ New York heart associa- tion, NYHA）, mode of delivery and outcomes of infants were compared between the groups. Results：①The rate of NYHA class Ⅰ-Ⅱ was 15/20 in slight group; The rate of NYHA class m-IV was 5/7 in moderate group; The rate of NYHA class Ⅲ-Ⅳ was 15/17 in severe group. ②The rate of term delivery was 11/20 and the birth weight was （ 2929±575 ） g on average in slight group. The rate of term delivery was 1/7, preterm la- bor 3/7in moderate group. The rate of term delivery was 2/17, preterm labor 10/17 in severe group. Two cases of very low birth weight premature children died outside the hospital in severe group. ③Twenty-two cases re- ceived caesarean section. ④Maternal mortality was 7%. The abortion rate for medical reasons was 27%. Con- dusion：The rate of NYHA class Ⅲ-Ⅳ increases gradually with the severity of pulmonary hypertension. The rate of premature children and Small for gestational age children increases in pregnant women with pulmonary hypertension complicating cardiac disease. Cesarean section is suitable for those women.

关 键 词：妊娠并发症 肺动脉高压 妊娠结局 

分 类 号：R543.2[医药卫生—心血管疾病]