摘要
目的 探讨妊娠合并主动脉夹层孕妇的临床特点,以及如何早期发现、早期干预,改善妊娠结局。方法 分析2000年1月至2020年6月广东省人民医院收治的12例妊娠合并主动脉夹层孕妇的临床资料。结果 12例孕妇中8例为Stanford A型夹层,4例为Stanford B型夹层。5例孕晚期Stanford A型夹层孕妇接受剖宫产+子宫切除术联合Bentall术,3例孕中期Stanford A型夹层孕妇孕期行Bentall术,2例孕晚期Stanford B型夹层孕妇行剖宫产分娩(其中1例产后进展为Stanford A型夹层遂行Bentall术),2例孕中期Stanford B型夹层孕妇均行剖宫取胎术。11例孕产妇术后存活,仅1例孕妇术后因多器官功能衰竭而死亡。7例孕晚期孕妇分娩的新生儿预后良好,5例孕中期孕妇均胎儿丢失。结论 虽然妊娠合并主动脉夹层是产科危急重症,如果早期识别并在多学科协作和及时合理的心脏外科手术干预下,可以获得良好的母儿结局。
Objective To investigate the clinical characteristics of pregnant women with aortic dissection and to study how to detect early,intervene early and improve the pregnancy outcome.Methods The clinical data of 12 pregnant women with aortic dissection were analyzed,who were treated in Guangdong Provincial People’s Hospital between January 2000 and June 2020.Results Among the 12 cases,8 cases were Stanford type A aortic dissection and 4 cases ware Stanford type B aortic dissection. Five patients with Stanford type A aortic dissection in the third trimester of pregnancy underwent cesarean section and hysterectomy combined with Bentall’s operation. Three patients with Stanford type A aortic dissection in the second trimester of pregnancy underwent Bentall’s operation during pregnancy. Two cases of Stanford type B aortic dissection in the third trimester of pregnancy underwent cesarean section,and Bentall’s operation was performed in 1 case who developed into Stanford type A aortic dissection. Two cases of Stanford type B aortic dissection in the second trimester of pregnancy were treated by cesarean section. Eleven pregnant women with aortic dissection survived,only one died of multiple organ failure. The prognosis of the newborn was good in 7 cases of late pregnancy,and there was fetal loss in 5 cases during the second trimester.Conclusions Although aortic dissection in pregnancy is a critical obstetric disease,good maternal and neonatal outcomes can be achieved if early identification,multidisciplinary cooperation and timely reasonable cardiac surgical intervention are carried out.
作者
吴淑燕
韩凤珍
WU Shu-yan;HAN Feng-zhen(Department of Obstetrics,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2022年第4期455-458,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
广东省医学科学技术研究基金项目(A2020623)。
关键词
主动脉夹层
妊娠
马凡综合征
aortic dissection
pregnancy
Marfan’s syndrome