妊娠合并感染性心内膜炎母婴结局分析

Analysis of pregnancy with maternal and fetal outcomes of infective endocarditis

目的:探讨妊娠合并感染性心内膜炎(IE)患者的妊娠结局。方法:2009年10月至2014年10月,我院收治6例妊娠合并IE的患者,回顾分析其临床资料,包括孕周、心内膜炎感染类型、心功能分级、终止妊娠方式、手术指征及母婴结局。结果:6例患者均患有心脏疾病,其中先天性心脏病3例(室间隔缺损1例,法洛四联症1例,动脉导管未闭1例),瓣膜病变(中-重度反流+关闭不全)3例。心脏手术5例。分娩方式:6例患者均行剖宫手术终止妊娠,其中2例剖宫产同时性心脏手术。母亲结局:6例患者均痊愈出院。胎儿结局:剖宫取胎术1例,早产4例,足月产1例。5例新生儿无畸形,存活4例,死亡1例。结论:孕期合并IE发病凶险,严重威胁母儿安全,致死率高,临床上须引起重视,积极治疗。妊娠期心脏手术是可行的,剖宫产是终止妊娠适宜的分娩方式。

Objective： To evaluate the pregnancy outcome of women with infective endocarditis（ IE）.Methods： Clinical data of 6 cases of pregnant women IE from October 2009 to October 2014 were analyzed retrosbectively,rewiew the patients chats for patient age,types of IE,cardiac functional classification,termination of pregnancy,surgical indications,and maternal-fetal outcomes. Results： The six patients were suffering from heart disease,among them three were congenital heart disease（ one ventricular septal defect,one postoperative tetralogy of Fallot and one patent ductus arteriosus）. Three cases had valve disease（ moderate-severe regurgitation and regurgitation）. Five patients accepted perinatal heart surgeries. Mode of delivery： The 6 patients who underwent caesarean operation to terminate pregnancy and two accepted cardiac surgery combined with cesarean section. Maternal outcomes： Six patients were cured. Fetal outcomes： one with cesarean section in second trimester,four of premature labor and one of full-term labor with cesarean section in third trimester. Five newborns were no malformation,four of whom were alive,one died. Conclusion： Pregnancy with IE is a dangerous disease which is a serious threat to maternal and fetal,the fatality rate is high,we must pay more clinical attention and take aggressive treatment. cardiac surgery during pregnancy is safe,cesarean section is an appropriate ways to terminate pregnancy.