妊娠合并重度肺动脉高压患者妊娠结局分析  

Analysis of pregnancy outcomes of pregnant women with severe pulmonary hypertension

作　　者：王君[1] 张军[1] 于新平[1] 李斌[1] 

机构地区：[1]首都医科大学附属北京安贞医院妇产科,100029

出　　处：《中国医药》2015年第6期872-874,共3页China Medicine

摘　　要：目的 探讨妊娠合并重度肺动脉高压患者的妊娠结局.方法 回顾性分析首都医科大学附属北京安贞医院2007年1月至2014年11月收治的120例妊娠合并重度肺动脉高压患者的临床资料,分析其心脏病类型、心功能级别、终止妊娠方式和母婴结局.结果 120例患者中继发性肺动脉高压106例,其中继发于先天性心脏病者103例（85.8％）,继发于风湿性心脏病者3例（2.5％）;原发肺动脉高压者14例（11.7％）.纽约心脏病协会心功能分析Ⅱ-Ⅳ级者119例（99.2％）.孕早、中期医源性终止妊娠55例（45.8％）,剖宫产61例（50.9％）,自然分娩1例（0.8％）,晚期难免流产2例（1.7％）,母胎死亡1例（0.8％）.孕产妇死亡9例（7.5％）.围生儿62例,活产58例（93.5％）,围生儿死亡4例（6.5％）;新生儿窒息11例（17.7％）,低体质量儿42例（67.7％）.结论 妊娠合并重度肺动脉高压可危及母婴健康甚至生命,应早期终止妊娠.Objective To evaluate the pregnancy outcomes of pregnant women with severe pulmonary hypertension.Methods Clinical data of 120 pregnant women with severe pulmonary hypertension from January 2007 to September 2014,including the types of heart disease,cardiac functional status,time and mode of pregnant termination and outcomes of the infants and mothers were retrospectively analyzed.Results There were 106 cases of secondary pulmonary hypertension [including 103 （85.8%） secondary to congenital heart disease and 3 （2.5%） secondary to rheumatic heart disease] and 14 cases （11.7%） of primary pulmonary hypertension.Totally 119 cases （99.2%） were New York Heart Association （NYHA） class Ⅱ-Ⅳ.In 120 patients,55 （45.8%） received iatrogenic abortion in the first and second trimester of pregnancy;61 （50.9%） received cesarean sections;1 underwent vaginal delivery （0.8%）;inevitable abortion occurred in 2 （1.7%） in the third trimester of pregnancy;1 mother and her fetal （0.8%） died.Totally 9 mothers （7.5%） died.In 62 perinatal infants,there were 58 （93.5%） of live birth,4 （6.5%） of death,11 cases （17.7%） of neonate asphyxia and 42 cases （67.7%） of low weight.Conclusion Pregnancy in patients with severe pulmonary hypertension can increase the mobility and motality of the maternal and baby and it should be terminated as soon as possible.Cesarean section is a relatively safe way in the second and the third trimester of pregnancy.

关 键 词：妊娠 重度肺动脉高压 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]