妊娠合并肺动脉高压孕产妇的临床特点及结局  

Clinical characteristics and outcomes of pregnant women combined with pulmonary hypertension

作　　者：喻淑慧 朱睿瑶[1] 邹捍东[1] 夏文芳[1] 詹丽英[1] YU Shuhui;ZHU Ruiyao;ZOU Handong;XIA Wenfang;ZHAN Liying(Dept.of Critical Care Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院重症医学科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2022年第4期542-546,共5页Medical Journal of Wuhan University

基　　金：湖北省中央引导地方科技发展专项基金(编号:2020ZYYD004)。

摘　　要：目的:研究妊娠合并肺动脉高压(PH)患者的临床特点及妊娠结局。方法:回顾性分析武汉大学人民医院2019年1月至2021年12月妊娠合并PH患者12例,比较不同严重程度的PH妊娠期间临床特点及妊娠结局。结果:12例妊娠合并PH患者包括初产妇5例、经产妇7例,重度PH患者平均年龄及孕周明显低于轻度、中度PH组,且随着肺动脉压越高,孕产妇心功能越差,发生早产、剖宫产、新生儿窒息比例增加。其中,重度PH组早产率及剖宫产率均为66.7%,且早产率高于轻度及中度组。妊娠合并PH患者的主要麻醉方式为硬膜外神经阻滞(75%),术后7例(58.3%)患者转入重症医学科继续治疗。结论:妊娠合并PH患者随着肺动脉压力增高,心功能分级越差,母婴妊娠结局也越差,妊娠合并重度PH患者提倡剖宫产终止妊娠。Objective:To study the clinical characteristics and pregnancy outcome analysis of high-risk pregnant women combined with pulmonary hypertension(PH)in pregnancy.Methods:We retrospectively analyzed 12 patients combined with PH in pregnancy from January 2019 to December 2021 at the Renmin Hospital of Wuhan University to compare the clinical characteristics and pregnancy outcomes of patients with PH of different severity during pregnancy.Results:The 12 patients in pregnancy combined with PH included 5 primipara and 7 pluripara.The mean age and gestational week of patients with severe PH were significantly less than those of the mild and moderate PH groups,and the rates of preterm delivery,cesarean section,and neonatal asphyxia increased with higher pulmonary artery pressure and poorer maternal cardiac function.Both the rates of preterm delivery and cesarean delivery were 66.7%in the severe PH group,and the rate of preterm delivery was higher than that in the mild and moderate PH groups.The main anesthetic modality for patients with combined PH in pregnancy was epidural nerve block(75%),and 7 patients(58.3%)were transferred to ICU for the following treatment postoperatively.Conclusion:In the pregnant women combined with PH,as the pulmonary artery pressure increases,the worse the cardiac function classification,the worse the pregnancy outcome for mother and baby,and cesarean section is advocated for termination of pregnancy when combined with severe PH.

关 键 词：妊娠 肺动脉高压 临床特点 结局 

分 类 号：R459.7[医药卫生—急诊医学]