妊娠合并心力衰竭30例临床分析  

Retrospective analysis of 30 pregnant womem complicated with heart failure

作　　者：孙晋萍[1] 翟建军[1] 樊庆泊[2] 

机构地区：[1]首都医科大学附属北京同仁医院妇产科,100176 [2]北京协和医院

出　　处：《中国综合临床》2013年第2期208-211,共4页Clinical Medicine of China

摘　　要：目的探讨妊娠合并心力衰竭对母儿的危险性。方法回顾分析1993年1月至2010年12月在首都医科大学附属北京同仁医院抢救的30例妊娠合并心力衰竭的临床资料并进行回顾性分析。分析病因、心力衰竭发生时间、终止妊娠时间、新生儿情况及孕产妇死亡情况。结果妊娠合并心力衰竭病例中先天性心脏病[12例（40％）]，风湿性心脏病[9例（30％）]，[妊娠高血压疾病7例（23％）]最多见。平均心力衰竭发生时间为（34．20±4．25）周。平均终止孕龄时间为（34．84±2．17）周；早产发生率为73．33％，平均新生儿体质量（2011±568）g，其中7例体质量〈2000g。无新生儿及产妇死亡。结论妊娠合并心力衰竭的主要病因为先天性心脏病、风湿性心脏病、重度妊娠高血压疾病。对于〈30周发生心力衰竭者应以终止妊娠为首选，而t〉30周者可积极治疗，改善心功能，促进胎儿发育，适时终止妊娠。围剖宫产期的正确处理可降低母婴病死率。Objective To investigate the risk of heart failure to the mother and the neonate. Methods The clinical data of 30 pregnant womem with heart failure from January 1993 to December 2010 from Capital Medical University Tongren Hospital was retrospectively analyzed. Results Of the 30 patients, there were 12 affected with congenital heart disease （40%）;9 with rheumatic heart disease 30%, 7 with heart failure in pregnancy-induced hypertension 23%. Heart failure appeared at the average of （34. 20 ± 4. 25 ） weeks in pregnancy. The average terminal time of pregnancy was （ 34. 84 ± 2. 17 ） weeks. The rate of early birth was 73.33%. The average birth weight was （2011 ±568） g, with 7 babies less than 2000 g. No death occurred in both new the mother and the neonate. Conclusion The main causes of heart failure in pregnancy are congenital and rheumatic heart disease and pregnancy-induced hypertension. For those heart failure occurs before 30 weeks, it is the first selection that pregnancy shoud he terminated; For those occur after 30 weeks, active treatment should be performed to improve maternal heart function and promote fetal maturity. Apropriate threatment during per-cesarean section may decrease the case fatality of the mother and neonate.

关 键 词：妊娠 心力衰竭 心脏病 

分 类 号：R714[医药卫生—妇产科学]