妊娠合并心脏病对母婴预后影响的临床分析

Clinical analysis of the impact of maternal-fetal prognosis of pregnancy with heart diseases

目的：探讨如何降低妊娠合并心脏病对母婴预后的影响。方法：收集我院2002年1月～2009年6月期间223例妊娠合并心脏病患者的临床资料对其进行回顾性分析。结果：妊娠合并心脏病的发病率为3.91%,先天性心脏病最常见。孕产妇死亡3例,新生儿死亡7例,胎死宫内1例。母婴预后与妊娠合并心脏病的种类相关。心功能Ⅰ～Ⅱ级患者与Ⅲ～Ⅳ级患者对母婴预后影响的差异有统计学意义。孕前行心脏手术者53例,孕期行经皮二尖瓣球囊扩张术8例,母婴预后良好。结论：妊娠合并心脏病严重危害母婴健康。加强宣教工作,增强孕龄妇女对妊娠合并心脏病的二级预防意识（早发现、早治疗）;孕前评估心脏功能确定能否胜任妊娠;孕期系统产检,可有效改善妊娠合并心脏病的母婴预后。

Objective：To investigate how to reduce to the impact of maternal-fetal prognosis in pre-gnant women with heart diseases.Method：Clinical data of 223 pregnant cases with heart diseases,collected from Beijing An zhen Hospital from January 2002 to June 2009,were analysed retrospectively.Result：The prevalence of pregnancy with heart diseases in total pregnant women was 3.91%.The congenital heart disease was most common.Three pregnant women, seven newborn and one intrauterine fetal were died respectively in our case. The maternal- fetal prognosis was related to the type of pregnancy with heart disease. Compared to pregnant women with the grade Ⅲ-Ⅳ heart function, the maternal -fetal prognosis in pregnant women with the grade Ⅰ-Ⅱ heart function have statistical difference. In 53 cases with heart Pre-pregnancy surgery, in 8 cases with underwent percutaneous balloon mitral valvuloplasty during Pre-pregnancy, Maternal- fetal prognosis is good. Conclusion： The pregnancy with heart diseases does seriously harm to the maternal-fetal health. Missionary work to strengthen and enhance secondary prevention （early detection, early treatment） awareness of heart diseases, in gestational age of pregnancy women, pre-assessment of heart function to determine the competency of pregnancy, the systematic prenatal visit can be effective in improving the mother -fetal prognosis of pregnancy with heart diseases.