先天性心脏病术后对妊娠结局的影响

Effect of Postoperative Congenital Heart Disease on Pregnancy Outcome

目的探讨妊娠合并先天性心脏病手术后对妊娠结局的影响。方法回顾性分析48例妊娠合并先天性心脏病患者的临床资料。结果 (1)妊娠合并心脏病患者以先天性心脏病居多(55.8%),类型以房间隔缺损和室间隔缺损为主(45.8%)。(2)手术组与未手术组比较,心功能Ⅲ～Ⅳ级与肺动脉高压的发生率降低(P<0.05);3例心衰均发生在未手术组,死亡1例;手术组无早产与围产儿死亡,而未手术组早产4例(26.7%),1例死亡。(3)妊娠合并先天性心脏病分娩方式以剖宫产为主(79.2%),手术组与未手术组比较,差别无统计学意义。结论妊娠合并先天性心脏病确诊后宜尽早手术治疗,术后再妊娠可降低母儿的发病率及死亡率;剖宫产终止妊娠是比较安全的分娩方式。

Objective To evaluate the effect of postoperative congenital heart disease on pregnancy outcome.Methods A retrospective study was conducted to review clinical data of 48 cases of pregnancy complicated with congenital heart disease from 2002～2009.Results（1） Congenital heart disease was the most common disease among pregnant women complicated with cardiac diseases（55.8%）,mainly with atrial septal defect and ventricular septal defect（45.8%）.（2） Compared with the unoperated group,the operated group showed decreased incidence of grade Ⅲ～Ⅳ heart function and pulmonary hypertension（P0.05）;there were 3 cases of heart failure,1 case of mother death,4 cases of premature birth,1 case of prenatal infant death in the unoperated group.（3）Caesarean section rate was 79.2% among all patients.Conclusions Surgery should be indicated for pregnant patients complicated with CHD,which can improve the pregnancy outcome and reduce the morbidity.Caesarean section is the better choice of safe delivery.