妊娠合并心脏病45例临床分析

Clinical Analysis of 45 Pregnant Women With Complicated Heart Diseases

目的:探讨妊娠合并心脏病对母儿预后的影响。方法:对我院2002年1月～2007年12月间45例妊娠合并心脏病患者的临床资料进行回顾性分析。结果:①妊娠合并心脏病患者以心律失常的发生率最高(13例,28.89%),其次为先天性心脏病(12例,26.67%)。②妊娠合并心脏病孕产妇病死率为4.44%(2/45),死亡专率为27.81/10万(2/7190)。③心功能Ⅳ级患者与心功能Ⅰ级、Ⅱ级、Ⅲ级患者比较,围生儿死亡率明显增加(P<0.01)。④分娩方式:经阴道自然分娩8例,占18.18%;阴道手术助产2例,占4.55%;剖宫产34例,占77.27%。结论:45例妊娠合并心脏病患者中,心律失常的发生率最高,心功能Ⅳ级患者围生儿死亡率明显增加,分娩方式的选择以剖宫产为主。

Objective：To investigate the outcome of pregnant women with complicated heart diseases.Method： Clinical data of 45 pregnant cases with heart disease,which were collected from Inner Mongolia Hospital during 2002～2007,were analysed retrospectively.Results： ①The most common cause of heart disease in pregnancy was cardiac arrhythmias（28.89%）.The incidence of congenital heart disease is on the second（12 cases,28.89%）.②The case fatality with pregnant women with complicated heart was 4.44%（2/45）,the maternal mortality rate was 27.81/100000（2/7190）.③The rates of perinatal fetal mortality in grade Ⅳ cardiac insufficiency were significantly higher than those in gradeⅠ、Ⅱ、Ⅲ cardiac insufficiency（P0.01）.④Mode of delivery： 34 cases（77.27%） delivered by cesarean section,2 cases（4.55%） by forcep delivery and 8 cases（18.18%） by vagnial delivery.Conclusion： The cardiac arrhythmias are the chief cause of pregnant women with complicated heart diseases.The rates of perinatal fetal mortality in grade Ⅳ cardiac insufficiency were significantly increasing.The cesarean section is the best mode of delivery.