心脏病手术后妊娠(附27例报告)

SURGERY OF HEART DISEASE ASSOCIATED WITH PREGNANCY: A REPORT OF 27 CASES

自1973~1987年间收治风湿性心脏病和先天性心脏病手术后妊娠27例(38次),其中早期流产8次,死胎4次,早产儿死亡1次。围产儿死亡率为74.7‰。27例孕妇中,除2例外,皆得1活婴。分娩方式中,阴道顺产7次,产钳产8次,剖宫产11次,剖宫产率为42%。心脏手术后能否妊娠,关键在于术后心脏功能改善情况。心功能不良者宜采用剖宫产术。本文对各种类型心脏病手术合并妊娠、妊娠结局和分娩方式进行了讨论。

Twenty-seven pregnant women with history of operation for rheumatic heart or congenital heart diseases admitted in 1973 to 1987 are reported.There were 8 early abortions,4 fetal death in uterus and one premature infant death in 38 pregnancies.Perinatal mortality rate was 74.7‰.Except 2 cases,all the mothers had a living birth.The mode of delivery was spontaneous vaginal delivery in 7 cases,forceps in 8 and cesarean section in 11.Cesarean section rate was 42%.Whether the women with heart surgery could conceive a child depends largely upon the cardiac function of patients.The chief threat in pregnant women with heart surgery is labor.Cesarean section should be used in patients with inadequate functional reserve.The various types of heart surgery associated with pregnancy,prognosis of pregnancy and the mode of delivery are discussed..