妊娠合并肺动脉高压孕妇的母儿结局分析  

Analysis of maternal and neonatal outcomes in pregnant women with pulmonary arterial hypertension

作　　者：吴亚楠 卢薇薇[1] Wu Yan-nan;Lu Wei-wei(Shangqiu First People's Hospital,Shangqiu 476000,Henan,China)

机构地区：[1]商丘市第一人民医院,河南商丘476000

出　　处：《四川生理科学杂志》2023年第5期761-764,共4页Sichuan Journal of Physiological Sciences

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210990)。

摘　　要：目的:分析62例妊娠合并肺动脉高压(Pulmonary arterial hypertension,PAH)孕妇的母儿结局。方法:选取2018年6月至2021年6月我院收治的62例妊娠合并PAH孕妇作为研究对象。所有患者中肺动脉收缩压≥80 mmHg者分为重度组(n=18),肺动脉收缩压为50~79 mmHg者分为中度组(n=20),肺动脉收缩压为30~49 mmHg者分为轻度组(n=24)。比较三组PAH病因、心功能、心电图、产妇结局及新生儿结局。结果:所有妊娠合并PAH孕妇中,主要病因为先天性心脏病,共30例(48.39%),其中房间隔缺损最为常见;三组PAH病因无明显差异(P>0.05);重度组心功能III~IV级率高于中度组、轻度组,中度组心功能III~IV级率高于轻度组(P<0.05);重度组电轴右偏率、右心室大率均高于中度组、轻度组,中度组电轴右偏率、右心室大率均高于轻度组(P<0.05);重度组分娩孕周早于中度组和轻度组,中度组分娩孕周早于轻度组(P<0.05);重度组足月分娩率低于中度组、轻度组,中度组足月分娩率低于轻度组(P<0.05);重度组医源性流产率、产后转入重症监护病房(Intensive Care Unit,ICU)率均高于中度组、轻度组,中度组医源性流产率、产后转入ICU率均高于轻度组(P<0.05);重度组新生儿体重低于中度组、轻度组,中度组新生儿体重低于轻度组(P<0.05);三组新生儿Apgar评分、新生儿窒息、转入新生儿重症监护病房(Neonatal intensive care unit,NICU)率比较无明显差异(P>0.05)。结论:先天性心脏病是妊娠合并PAH的主要病因,重度PAH孕妇出现不良母儿结局的风险显著增加,应严格避孕或妊娠早期终止妊娠。Objective:To analyze maternal and neonatal outcomes in the 62 pregnant women with pulmonary arterial hypertension(PAH).Methods:A total of 62 pregnant women with PAH admitted to the hospital were enrolled as the research objects between June 2018 and June 2021.According to different pulmonary artery systolic pressure,they were divided into severe group(≥80mmHg,n=18),moderate group(50-79mmHg,n=20)and mild group(30-49mmHg,n=24).The causes of PAH,cardiac function,electrocardiogram,maternal outcomes and neonatal outcomes were compared among the three groups.Results:Among all pregnant women with PAH,there were 30 cases(48.39%)with congenital heart disease,mainly on atrial septal defects.There was no significant difference in the causes of PAH among the three groups(P>0.05).The incidence of cardiac function at grade III-IV was the highest in severe group,followed by moderate group and mild group(P<0.05).The incidence rates of right axis deviation and right ventricular hypertrophy were the highest in severe group,followed by moderate group and mild group(P<0.05).The gestational age of delivery was the earliest in severe group,followed by moderate group and mild group(P<0.05).The full-term delivery rate was the highest in mild group,followed by moderate group and severe group(P<0.05).The incidence rates of iatrogenic abortion and postpartum transfer to intensive care unit(ICU)were the highest in severe group,followed by moderate group and mild group(P<0.05).The neonatal weight was the highest in mild group,followed by moderate group and severe group(P<0.05).There was no significant difference in Apgar score or incidence of neonatal asphyxia and transfer to neonatal intensive care unit(NICU)among the three groups(P>0.05).Conclusion:Congenital heart disease is the main cause of pregnancy combined with PAH.The risk of adverse maternal and neonatal outcomes is significantly higher in pregnant women with severe PAH.Strict contraception or early pregnancy termination should be carried out.

关 键 词：妊娠 肺动脉高压 母儿结局 心功能 

分 类 号：R714.25[医药卫生—妇产科学]