47例妊娠合并心衰的诊断与处理

Diagnosis and menagement of 47 cases of pregnancy with heart failure

目的探讨妊娠合并心衰的诊断与处理。方法对４７例妊娠期合并各种类型心衰，根据诊断作不同处理。结果４７例妊娠合并心衰中，２例心衰控制后回原地分娩，２例中孕引产，３例于妊娠期死亡，其中１例存活７个月４天后死亡。新生儿４４例（４例双胎），早产儿死亡１例，存活４３例。结论妊娠合并心衰结合临床特点，给予扩张血管、利尿、增加心肌收缩力药物治疗、二尖瓣狭窄扩张术及呼吸机改善肺通气。

Objective To appraise the diagnosis and mamagement of pregnancy complicated with heart failure. Methods The managment scheme should be individualized since the heart failure varied inetiologies.Results The heart failure was controlled in two of these patients and they returned to their regional hospital for delivery, in two, abortion was induced, three died, of whom one died seven months after the delivery, except the three, all others were recovered. Among the 44 neonates including 4 twins, all were delivered in good health, except one baby died of prematurity.Conclusion Vasodilators, diuretics and inotropic agents were used in these cases, mitral comissurotomy and use of ventilator enable satisfactory delivery.