心脏换瓣术后妊娠分娩36例临床观察

Clinical observation on 36 cases with delivery of post mitral valve replacement pregnancy

目的:探讨心脏换瓣术后妇女妊娠分娩的处理方案。方法:对近十余年来收住的36例孕妇,观察其分娩方式、妊娠结局及分娩前抗凝药物应用方案。结果:36例预后均良好,其中34例行硬膜外麻醉下剖宫产术,术前24～48h停用抗凝药,必要时注射维生素K120mg,术后24h恢复抗凝药的应用,产妇均未出现严重并发症,婴儿无畸形等发生。结论:换瓣术后以剖宫产为首选方式,术前及时停用抗凝药物,术后24h恢复用药,对产妇及新生儿是一种安全的处理方案。

Objective： To evaluate treatment project on pregnancy women with prosthetic heart vavle replacement. Methods： Clinical observation on delivery model and outcome and application program of anticoagulant drugs with 36 cases pregnancy women with prosthetic heart vavle replacment in recent 10 years. Results： 34 ases were operated cesarean section in epidural anesthesia. Anticoagulant drug was stopped preoperative 24 - 48 hours. Vitamin K120 mg was injected in necessary. Anticoagulant drug was reused 24 hours after operation. All pregnancy women had no serious complication and fetus neonate had no malformation. Conclusion： Cesarean section is of choice for pregnancy women with prosthtic vavle replacement. Anticoagulation drug is stopped preoperation in time and reused after operation promptly. This project should be safe on pregnancy women and neonate.