妊娠合并先天性心脏病伴肺动脉高压患者的妊娠结局分析

The Pregnancy Outcomes of Women Combined With Congenital Heart Disease With Pulmonary Hypertension

目的探讨妊娠合并先心病伴肺动脉高压患者的妊娠结局。方法对我院从2012年6月-2016年7月收治的50例妊娠合并先心病伴肺动脉高压患者的临床资料进行回顾性分析,根据肺动脉压力分为轻中重三组,分析各组心功能级别、终止妊娠方式及围产结局。结果重度组心功能较差,心功能III^IV级者有较高的心力衰竭、新生儿早产及低出生体重儿发生率,与I^II级组相比差异有统计学意义(P<0.05);中重度组新生儿出生体重偏低,重度组新生儿出生孕龄较小,分别与轻度组相比,差异有统计学意义(P<0.05);约56%的患者心律异常;剖宫产是终止妊娠的主要方式。结论随着肺动脉压力的增加,不良妊娠结局发生率越高;肺动脉压轻中度升高,心功能及软产道条件好,可经阴道试产。

Objective To evaluate pregnancy outcomes of women combined with congenital heart disease with pulmonary hypertension. Methods A retrospective review of 50 pregnant patients combined with CHD with pulmonary hypertension was done from June 2012 to July 2016. Those patients were divided into three groups according to pulmonary hypertension, cardiac status, deliver way and maternal and fetal outcome were compared among different groups. Results The cardiac function of severe group was worse, there was significant difference in occurrence rate of heart failure, preterm birth and low birth weight between patients with class III-IV cardiac function and class I to II cardiac function; The moderate and severe group had lower birth weights, the severe group had more preterm births, there was significant difference compared with mild group respectively; All patients were about 56% combined abnormal heart rhythms; Cesarean section is the main way to terminate pregnancy. Conclusion With the increase of pulmonary artery pressure, the higher the incidence of adverse pregnancy outcome; Patients with mild-to-moderate increased pulmonary artery pressure and good condition of cardiac function and soft birth canal have a chance of vaginal delivery.