135例妊娠期心衰处理及分娩结局的临床观察  

Clinical observation of delivery outcome in 135 cases of pregnancy with heart failure

作　　者：谭玲[1] 冯菊华[1] 

机构地区：[1]广元市中心医院科教科,四川广元628000

出　　处：《四川医学》2013年第12期1860-1862,共3页Sichuan Medical Journal

摘　　要：目的 探讨妊娠期心衰的临床处理,及终止妊娠时间、分娩方式选择对围产儿预后的临床影响.方法 我院2009年3月～2012年6月共135例妊娠期心衰患者,根据分娩方式、分娩时机、心衰控制时间和术前心功能状态进行分组,比较不同分组对围产儿预后的影响.结果 阴道分娩终止妊娠,新生儿窒息发生率较剖宫产显著增高,P〈0.05;37～39＋6孕周剖宫产较32～36＋6孕周剖宫产围产期死亡率显著增高,P〈0.05,低体重儿发生率显著降低,P〈0.05;控制心衰时间大于48h,新生儿窒息风险显著增加,P〈0.05,新生儿肺透明膜病发生率亦显著增加,P〈0.05;心功能Ⅰ~Ⅱ级剖宫产较Ⅲ~Ⅳ剖宫产新生儿窒息发生率和围产期死亡率显著降低,P〈0.05.结论 妊娠期心衰应选择剖宫产终止妊娠,最好在32～36＋6孕周内,根据母亲心功能状态选择手术时机.Objective To observe the delivery outcome in 135 cases of pregnancy with heart failure. Methods 135 ca- ses with pregnancy complicated heart failure in our hospital from March 2009 to June 2012, were divided into different groups by different delivery way, delivery timing, control time of heart failure, preoperative cardiac function, there prognosis were com- pared. Result The neonatal asphyxia occurrence rate of vaginal delivery was higher than cesarean delivery, P 〈 0. 05 ; the neo- natal death rate of cesarean delivery during 37 -39 ＋6 was higher than cesarean delivery during 32 -36 ＋6, p 〈0. 05 ,and the in- fant low-birth weight occurrence rate was lower, P 〈 O. 05 ; the neonatal asphyxia occurrence rate of cesarean delivery operated after 48h of heart failure control time was higher than during 24h, P 〈 0. 05, and the hyaline membrane disease occurrence rate was higher, P 〈 0. 05 ; the neonatal asphyxia occurrence rate and neonatal death rate of cesarean delivery with I - II cardiac function was lower than III- IV cardiac function, P 〈 0. 05. Conclusion The cesarean delivery should be selected to termination of preg- nancy in pregnant woman with heart failure, operation opportunity should decided in the basis of pregnant woman＇s cardiac func- tion, it should be best operated cesarean delivery during 32 ~ 36 ＋6 gestational weeks.

关 键 词：妊娠 心衰 分娩时机 分娩方式 

分 类 号：R714.25[医药卫生—妇产科学]