妊娠合并心衰30例临床分析

Retrospective Analysis of 30 Pregnant Womem Complicated Heart Failure

目的：探讨妊娠合并心衰对母儿的危险性。方法：回顾分析1998年1月～2004年12月在我院抢救的30例妊娠合并心衰的临床资料。结果：妊娠合并心衰病例中妊高征性心脏病占30％，先心占26％，风心占23％；平均心衰发生时间是孕（29．30±6．23）周，平均终止孕周时间为（34．84±2．17）周；早产发生率为57．14％，平均新生儿体重2421g，其中8例体重〈2000g；围产期孕产妇死亡1例（3．33％），围产儿死亡5例（17．85％）。结论：妊娠合并心衰的主要病因为重度妊高征、先心和风心；积极正确地综合治疗可降低母婴死亡率；对于〈30周发生心衰者应以终止妊娠为首选，而≥30周者可积极治疗，改善心功能，促进胎儿发育，适时终止妊娠。

Objective： To research and discuss the dangers of heart failure to the mother and the neonate. Methods： Retrospective analysis the clinical data of our hospital that 30 pregnant womem with heart failure from January 1998 to December 2004. Results： The rate of heart failure in pregnancy - induced hypertension was 30% （ n = 9 ） ; congenital heart disease was 26% （ n = 8 ） ; rheumatic heart disease was 23% （n =7） . Heart failure appeared at the average of 29. 30 ＋ 6. 23 weeks in pregnancy. The average terminal time of pregnancy was 34. 84±2. 17 weeks. The rate of early birth was 57. 14%. The average weigh of new born was 2 421 g with 8 babies less than 2 000 g. The maternal mortality was 3. 33% and the perinatal mortality was 17. 85%. Conclusion： The main causes of heart failure in pregnancy are pregnancy -induced hypertension and congenital and rheumatic heart diseases. Actively integrate treatment can reduce the mortality of the mother and the neonate. It is the first selection that pregnancy should be terminated if heart failure occurs before 30 weeks. It should be active treatment and improve maternal heart function and promote fetal maturity after pregnancy 30 weeks and C - section should be performed in time.