妊娠合并艾森曼格综合征1例并文献复习

Eisenmenger's syndrome in pregnancy: a case report and literature review

艾森曼格综合征（Eisenmenger’s syndrome，ES）是指各种先天性心脏病导致的肺动脉压力逐渐升高，达到或超过体循环压力，最终血液通过心内或心外异常通路产生双向或右向左分流，患者出现紫绀、活动耐力下降、呼吸困难等一系列表现的综合征。当先天性心脏病患者发展为ES时，往往预示着已经失去最佳手术治疗时机。

Objective： To investigate the clinical presentation, diagnosis and treatment of the Eisenmenger＇ s syndrome in pregnancy. Methods： One case of Eisenmenger＇ s syndrome in pregnancy in our hospital was retrospectively analyzed and the literature reviewed. Results： This patient who received antenatal care irregularly in other hospital was diagnosed with Eisenmenger＇ s syndrome with the symp- toms of chest distress. The other hospital suggested her to terminate pregnancy, but the patient refused. She was admitted to our hospital in her late pregnancy, received the treatment of rest, oxygen, blood gas and pulmonary artery pressure monitoring. Considering perioperative pulmonary hypertension crisis likely to occur, pulmonary artery catheter was placed preoperatively. In general anesthesia, the cesarean was performed. After operation, the patient was transferred to the intensive care unit, with the treatment of expanding blood vessels, reducing pulmonary artery pressure, administering anticoagulation and preven- ting infection. One week later, the patient was discharged from hospital with smooth condition. Conclu- sion： Eisenmenger＇ s syndrome in pregnancy is associated with extremely poor maternal and fetal out- come. Termination of pregnancy should be offered to such patients. When interruption of pregnancy is re- fused, the early hospital admission is needed. The patients should be managed in a high-risk pregnancy unit by a multidisciplinary team from obstetrics, cardiology, anesthesia and pediatrics for improving pregnancy outcomes.