妊娠合并Ebstein畸形二例  

Pregnancy Complicated with Ebstein Anomaly:Two Cases Report

作　　者：马国霞 王佳丽 苗贺瑱 闫宇 刘佳佳 杨永秀[2] MA Guo-xia;WANG Jia-li;MIAO He-zhen;YAN Yu;LIU Jia-jia;YANG Yong-xiu(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China;Department of Obstetrics and Gynecology,The First Hospital of Lanzhou University,Gansu Provincial Clinical Research Center for Gynecological Oncology,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,730000 [2]兰州大学第一医院妇产科,甘肃省妇科肿瘤临床研究中心

出　　处：《国际妇产科学杂志》2024年第6期624-628,共5页Journal of International Obstetrics and Gynecology

摘　　要：Ebstein畸形(Ebstein anomaly)又称三尖瓣下移畸形,是一种罕见的先天性心脏疾病,与三尖瓣移位和功能不全有关。Ebstein畸形的孕妇在妊娠期间因心血管系统发生的变化,心力衰竭和心律失常的风险很高,容易发生不良妊娠结局,管理也会面临很大的挑战。现报告2例妊娠合并Ebstein畸形的病例,1例在妊娠早期产检时发现心脏Ebstein畸形,于妊娠中晚期出现气短等症状,经积极监测对症治疗后于孕37^(+1)周剖宫产分娩一活婴。另1例因妊娠前房间隔缺损行手术治疗,此次妊娠期无明显心脏症状,未行心脏彩色超声检查,孕38^(+1)周要求入院行剖宫产终止妊娠时发现心脏Ebstein畸形,于孕38^(+6)周剖宫产分娩一活婴。2例产妇及胎儿均预后良好。结合这2例妊娠合并Ebstein畸形并足月分娩活婴的病例,复习国内外相关文献,对该疾病进行讨论并加深认识,以便更好地管理妊娠合并Ebstein畸形孕妇。Ebstein anomaly,also known as tricuspid valve subluxation malformation,is a rare congenital heart disease associated with tricuspid valve displacement and insufficiency.Pregnant women with Ebstein anomaly have a high risk of heart failure and arrhythmia due to changes in the cardiovascular system during pregnancy,which leads to adverse pregnancy outcomes and management challenges.We report two cases of Ebstein anomaly in pregnancy,one with cardiac Ebstein anomaly was detected during prenatal examination in early pregnancy,who presented with shortness of breath and other symptoms in mid to late pregnancy.She delivered a live baby by cesarean section at 37^(+1) weeks of gestation after active monitoring and symptomatic treatment.The other case underwent surgery for atrial septal defect before pregnancy,there were no obvious cardiac symptoms during this pregnancy,and no cardiac ultrasound examination was performed.At 38^(+1) weeks of pregnancy,she requested admission for cesarean section to terminate the pregnancy and Ebstein anomaly was detected during the examination.She delivered a live baby by cesarean section at 38^(+6) weeks of gestation.The two cases had good prognosis for both the mothers and the fetuses.Combining these 2 cases of pregnancy complicated with Ebstein anomaly and full-term delivery of live babies and reviewing the relevant domestic and international literature,to discuss and deepen the understanding of the disease,in order to better manage pregnant women with Ebstein anomaly.

关 键 词：EBSTEIN畸形 心脏缺损 先天性 孕妇 妊娠 妊娠结局 

分 类 号：R714.252[医药卫生—妇产科学]