235例妊娠合并心脏病围产期的处理

Perinatal management of 235 pregnancies complicatedwith heart disease.

分析了１９７８年至１９９１年妊娠合并心脏病２３５例的临床资料，结果表明患病率为１％，产妇病死率１７‰，心脏病孕产妇病死率占非产科原因死亡的第一位。围产儿病死率为５９．６‰。本组剖宫产率为３６．１％，其中心功能Ⅲ、Ⅳ级者１５例，占６．４％。认为改善母婴预后的关键在于良好的孕产妇系统管理及高危妊娠的临护，积极防治贫血、妊高征、产程延长及各种并发症，适时终止妊娠可获良好的妊娠结局。

Objective:To determine the perinatal outcome ofpregnancies complicated with heart disease. Design:Retrospectively analyzed 235 cases of pregnanciescomplicated With heart diease who had been treatedbetween 1978 and 1991 in the obstetrical unite of ourhospital. Results: The maternal mortality was 0.68,and heart disease being the main cause of non-obstetrical deaths. The rates of postpartum hemorrhage,puerperal infection and perinatal death were 6.44%,1. 29% and 59. 6%, respectively and were markedlyhigher in the pregnant women with heart disease thanthose in the control group (non-heart disease ). Among the 84 cases who had undergone cesarean section (36.1%), there was no maternal and perinataldeath. Conclusion: This study suggested that the appropriate medical and surgical management and closelymonitoring of pregnant women with heart diseaseshould be recommended. Active measures should betaken to prevent anemia, PIH, prolonged labour andother complications