西藏地区单中心妊娠合并先天性心脏病50例分析

An analysis of 50 cases of single-center pregnancy complicated with congenital heart disease in Xizang

目的探讨西藏高原地区单中心妊娠合并先天性心脏病对孕产妇及围产儿的影响。方法回顾性分析2018年3月至2023年3月在西藏自治区人民医院产科住院分娩的50例妊娠合并先天性心脏病产妇临床资料,将孕前行心脏矫治手术的10例产妇为观察组,孕前未行心脏矫治手术的40例产妇为对照组,分析比较两组产妇心功能级别、新生儿Apgar评分及围产儿结局。结果50例病例中,先心病类型以房间隔缺损(52%)和动脉导管未闭(28%)为主;孕前行心脏病手术患者的心功能以I~II级为主,孕前未行心脏病手术患者的心功能以III~IV级为主,两组间对比P<0.05,有统计学意义;观察组早产1例(10%),对照组早产21例(52.5%),两组间对比P<0.05,有统计学意义;观察组出现新生儿窒息1例(10%),对照组出现新生儿窒息24例(60%),两组间对比P<0.05,有统计学意义;观察组新生儿5分钟Apgar评分为(9.8±0.1),对照组新生儿5分钟Apgar评分为(8.2±0.2),两组间对比P<0.05,有统计学意义;观察组新生儿体质量为(3003.5±166.1),对照组新生儿体质量为(2500.5±92.5),两组间对比P<0.05,有统计学意义。结论孕前行心脏矫治手术能显著降低早产率及新生儿并发症的发生率,改善孕妇心脏情况,无手术禁忌证的孕产妇在孕前应积极治疗先天性心脏病。

Objective To investigate the effects of single center pregnancy complicated with congenital heart disease on maternal women and perinatal infants in the Xizang Plateau area.Methods The clinical data of 50 pregnant women with congenital heart disease who gave birth in the obstetrics department of the People's Hospital of Xizang Autonomous Region from March 2018 to March 2023 were retrospectively analyzed.Ten women who underwent corrective cardiac surgery before pregnancy were selected as the observation group,and another 40 pregnant women who did not undergo corrective cardiac surgery before pregnancy were used as the control group.The cardiac function level,neonatal Apgar score and perinatal outcomes of the two groups were analyzed and compared.Results Among the 50 cases,the main types of congenital heart disease were atrial septal defect(52%)and patent ductus arteriosus(28%).The cardiac function of patients undergoing cardiac surgery before pregnancy was mainly grade I to II,and that of pa-tients without cardiac surgery before pregnancy was mainly grade III to IV.The comparison between the two groups was P<0.05,which was statistically significant.There was 1 case of preterm birth in the observation group(10%)and 21 cases in the control group(52.5%),and the P<0.05 between the two groups was statistically significant.There was one case(10%)of neonatal asphyxia in the observation group and 24 cases(60%)in the control group,and the P<0.05 between the two groups was statistically significant.The 5-minute Apgar score of neonates in the observation group was(9.8±0.1),and that in the control group was(8.2±0.2),and the P<0.05 was statistically significant between the two groups.The body weight of neonates in the observation group was(3003.5±166.1),and that in the control group was(2500.5±92.5),and the comparison between the two groups was P<0.05,which was statistically significant.Conclusion The corrective cardiac surgery before pregnancy can significantly reduce the incidence of preterm birth and neonatal complications,improve the cardiac condition of pregnant women,and pregnant women without surgical contraindications should actively treat congenital heart disease before pregnancy.