妊娠合并心脏病不同心功能状态分娩方式的选择及其与母儿预后的关系

Pregnancy with heart disease of different cardiac function in the choice of the ways of childbirth and the relationship of maternal-fetal prognosis

目的探讨妊娠合并心脏病不同心功能状态分娩方式的选择及其与母儿预后的关系。方法对2002年2月至2011年2月在新疆医科大学第一临床医学院住院分娩的102例妊娠合并心脏病患者临床资料进行回顾性分析。结果①实际分娩的102例妊娠合并心脏病患者中,先天性心脏病所占比例最高,其次是心律失常。②孕前心脏手术后妊娠能够明显改善妊娠妇女的心功能状况,使其安全渡过妊娠分娩期。③心功能III-IV级组剖宫产率高于心功能I-II级组(P<0.05)。④心功能III-IV级组早产、足月低体重儿、新生儿窒息、围生儿死亡发生率均高于心功能I-II级组(P<0.05);心功能III-IV级平均分娩孕周、新生儿平均体重均低于心功能I-II级(P<0.05)。结论妊娠合并心脏病患者心脏病类型的构成情况与国内外报道基本一致。心脏手术后妊娠明显改善孕产妇围产期心功能,使妊娠结局良好。心功能III-IV级者均应行剖宫产终止妊娠。母亲心功能状态直接影响妊娠结局。

Objective： To investigate pregnancy with heart disease of different cardiac function in the choice of the ways of childbirth and the relationship of maternal-fetal prognosis.Methods： Clinical data of 102cases of pregnant women with heart diseases in the Obstetrics in First Clinical Medical School of Xinjiang Medical University from February 2002 to February 2011 were analyzed retrospectively.Results：（1） In 102 patients,congenital heart disease is the highest proportion,the second is arrhythmia.（2） The cardiac surgery before pregnancy can obviously improve the cardiac function of pregnant women,make its security through the pregnancy during delivery.（3） Cardiac function level III-IV group cesarean section rate was higher than the cardiac function level I-II group（P0.05）.（4） The incidence of premature delivery,low weight of newborns,suffocation and perinatal mortality of neonates were higher in women with cardiac function level III-IV group than those women with cardiac function level I-II group（P0.05）;The patients average gestational ages and neonatal weight were lower in women with cardiac function level III-IV group than those women with cardiac function level I-II group（P0.05）.Conclusion： The incidence of pregnancy women with heart disease was basically the same with related reports at home and abroad.Pregnancy after heart operation can obviously improve maternal perinatal cardiac function,which make the pregnancy outcome good.The women with cardiac function level III-IV group all should do cesarean section termination of pregnancy.The mother＇s heart function state directly influence the pregnancy outcome.