妊娠合并艾森曼格综合征34例母胎结局及临床分析  

Materna-fetal Outcomes and Clinical Analysis of 34 Cases of Pregnancy Complicated with Eisenmenger Syndrome

作　　者：张道燕 刘婷[2] 张露 ZHANG Daoyan;LIU Ting;ZHANG Lu(Department of Obstetrics and Gynecology,People,s Hospital of Qihe County,Dezhou 251100,China;Department of Obstetrics and Gynecology,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Obstetrics and Gynecology,Affiliated Provincial Hospital of Shandong First Medical University,Jinan 250021,China)

机构地区：[1]德州市齐河县人民医院妇产科,山东德州251100 [2]山东大学齐鲁医院妇产科,山东济南250012 [3]山东第一医科大学附属省立医院妇产科,山东济南250021

出　　处：《中国医药指南》2023年第16期5-8,共4页Guide of China Medicine

基　　金：山东省自然科学基金(ZR2020QH043)。

摘　　要：目的探讨妊娠合并艾森曼格综合征的母胎结局及临床特点。方法回顾分析2008年1月至2021年6月山东大学齐鲁医院收治并分娩的34例妊娠合并艾森曼格综合征患者的临床资料。结果34例患者中,以晚期妊娠(22/34,64.71%)常见;合并症以妊娠期高血压疾病(8/34,23.53%)多见。先天性心脏病以室间隔缺损(18/34,52.94%)和动脉导管未闭(9/34,26.47%)多见;平均肺动脉压力为(104.4±26.85)mmHg,28例(82.35%)出现重度肺动脉高压;平均动脉血氧饱和度(79.16±14.71)%。终止妊娠的平均孕周为(28.61±10.05)周;终止妊娠方式包括剖宫产/剖宫取胎(24/34,70.59%),阴道分娩(5/34,14.71%)和刮宫术(5/34,14.71%);麻醉方式以硬膜外麻醉为主(15/28,53.57%);6例(17.65%)自动出院,18例(52.94%)好转出院,10例(29.41%)死亡。胎儿或者新生儿死亡13例(38.24%),活产21例(61.76%),小于胎龄儿7例(33.33%)。心功能Ⅲ~Ⅳ级、重度缺氧以及出现合并症时患者病死率更高(P<0.05)。结论妊娠合并艾森曼格综合征母胎预后不良,应尽量避免妊娠。妊娠期间需要多学科协作制订个性化的诊疗方案,使其安全渡过围生期,改善母胎预后。Objective To discuss the maternal-fetal outcomes and clinical characteristics of pregnancy complicated with eisenmenger syndrome.Methods A retrospective analysis of 34 cases of pregnancy complicated with eisenmenger syndrome who were admitted and delivered in Qilu Hospital of Shandong University from January 2008 to June 2021 clinical data of patients.Results Among the 34 patients,late pregnancy was common(22/34,64.71%),and complication of pregnancy-induced hypertension was more common(8/34,23.53%).Ventricular septal defect(18/34,52.94%)and patent ductus arteriosus(9/34,26.47%)were more common congenital heart diseases;the mean pulmonary artery pressure was(104.4±26.85)mm Hg,and 28 patients(82.35%)had severe pulmonary hypertension;mean arterial oxygen saturation was(79.16±14.71)%.The average gestational week of pregnancy termination was(28.61±10.05)weeks;the methods of pregnancy termination included cesarean section/cesarean section(24/34,70.6%),vaginal delivery(5/34,14.71%)and curettage(5/34,14.71%);epidural anesthesia was the main anesthesia method(15/28,53.59%);6 patients(17.65%)were discharged automatically,and 18 patients(52.94%)were discharged after improvement,10 patients(29.41%)died.There were 13 patients(38.24%)fetal or neonatal deaths,21 patients(61.76%)live births,and 7 patients(33.33%)small-for-gestational-age infants.The mortality rate of patients with cardiac function gradesⅢtoⅣ,severe hypoxia and complications was higher(P<0.05).Conclusion Pregnancy complicated with eisenmenger syndrome has poor maternal and fetal prognosis,and pregnancy should be avoided as much as possible.During pregnancy,multidisciplinary collaboration is required to formulate a personalized diagnosis and treatment plan,so that it can safely pass through the perinatal period and improve the prognosis of the mother and the fetus.

关 键 词：妊娠 艾森曼格综合征 母胎结局 围生期 

分 类 号：R714.2[医药卫生—妇产科学]