合并结构性心脏病孕妇的妊娠结局分析  

Analysis of Pregnancy Outcomes in Pregnant Women with Structural Heart Disease

作　　者：李巧荣 龙湘党[1] 敖琨[1] 谢娟娟[1] 卓宇 文琼莉 LI Qiaorong;LONG Xiangdang;AO Kun(Department of Medical Ultrasound,Hunan Provincial People's Hospital/First Affiliated Hospital of Hunan Normal University,Changsha Hunan 410005)

机构地区：[1]湖南省人民医院/湖南师范大学附属第一医院超声医学科,湖南长沙410005

出　　处：《医学临床研究》2023年第10期1441-1443,1447,共4页Journal of Clinical Research

基　　金：湖南省临床医疗技术创新引导项目(编号:2018SK50706)。

摘　　要：【目的】探讨合并结构性心脏病孕妇的妊娠结局。【方法】回顾性分析40例诊断为结构性心脏病孕妇(观察组)的临床资料,另外选取80例健康孕妇(对照组)的临床资料,比较两组妊娠结局。【结果】40例合并结构性心脏病孕妇中,风湿性心脏病10例(10/40,25.00%),先天性心脏病30例(30/40,75.00%)。观察组死胎、早产、医源性胎儿丢失发生率、孕妇围产期死亡率、孕妇入ICU率、剖宫产率、新生儿入新生儿重症监护病房(NICU)率均高于对照组(P<0.05);新生儿出生体重、1 min及5 min Apgar评分、出生孕周均低于对照组(P<0.05)。观察组孕妇中纽约心脏病协会(NYHA)分级Ⅲ~Ⅳ级组胎儿早产、孕妇围产期死亡率、剖宫产的发生率及新生儿入NICU率均高于NYHA分级Ⅰ~Ⅱ级组(P<0.05),新生儿出生体重及孕周均低于NYHA分级Ⅰ~Ⅱ级组(P<0.05)。【结论】合并结构性心脏病孕妇不良妊娠结局发生率高,尤其是NYHA分级Ⅲ~Ⅳ级的孕妇。【Objective】To investigate the pregnancy outcomes of pregnant women with structural heart disease.【Method】The clinical data of 40 pregnant women diagnosed with structural heart disease(observation group)and 80 healthy pregnant women(control group)were retrospectively analyzed,and the pregnancy outcomes of the two groups were compared.【Results】Among the 40 pregnant women with structural heart disease,10 cases(10/40,25.00%)were rheumatic heart disease and 30 cases(30/40,75.00%)were congenital heart disease.The incidences of stillbirth,premature birth,iatrogenic fetal loss,perinatal mortality,ICU admission,cesarean section,NICU admission in the case group were higher than those in the control group(P<0.05).The birth weight,Apgar score at 1 and 5 minutes and the gestational age of neonates in the case group were lower than those in the control group(P<0.05).The incidences of premature birth,perinatal death,cesarean section and NICU admission in the NYHA gradeⅢ-Ⅳgroup were higher than those in NYHA gradeⅠ-Ⅱgroup(P<0.05).The birth weight and the gestational age of neonates in the NYHA gradeⅢ-Ⅳgroup were lower than those in NYHA gradeⅠ-Ⅱgroup(P<0.05).【Conclusion】There is a high incidence of adverse pregnancy outcomes in pregnant women with structural heart disease,especially in those with NYHA gradeⅢ-Ⅳ.

关 键 词：妊娠 心脏病 妊娠结局 

分 类 号：R541.61[医药卫生—心血管疾病]