妊娠合并艾森曼格综合征的诊断与治疗

Diagnosis and treatment of Eisenmenger's syndrome during pregnancy

目的 探讨妊娠合并艾森曼格综合征的临床表现、诊断、妊娠结局与治疗方法。 方法 回顾分析 2例妊娠合并艾森曼格综合征患者的临床资料。 结果 第 1例患者孕 34+ 4 周临产入院 ,阴道分娩后即刻出现烦躁、呼吸急促、呼吸困难而死亡 ,临床考虑为肺栓塞。第 2例患者因发现胎儿生长受限入院 ,口唇及甲床紫绀加重 ,于孕 35 + 4 周剖宫产 ,产后 2周平安出院。 结论 妊娠合并艾森曼格综合征母儿的结局不良 ,该患者不宜妊娠 ,婚后应采取避孕措施。一旦妊娠应在早期终止。如果患者拒绝终止妊娠 ,应加强监护 ,尽最大努力保护母儿的生命安全。

Objective To investigate clinical presentation, diagnosis,gestational outcome and treatment of Eisenmenger’s syndrome during pregnancy. Methods Two patients with Eisenmenger’s syndrome during pregnancy were reported retrospectively. Results The first case was admitted in labor at 34 weeks and 4 days in pregnancy,She had dysphoria,tachypnea and dyspnea right after vaginal delivery and died immediately The diagnosis of pulmonary embolism was highly suspected clinically. The second case was admitted because of fetal growth restriction Cesarean section was performed after cyanosis worsened at 35 weeks and 4 days She was discharged from the hospital two weeks after delivery. Conclusion Eisenmenger’s syndrome during pregnancy was associated with extremely poor maternal and fetal outcome Pregnancy is contraindicated in such patients Contraception is necessary after marriage Pregnancy should be terminated as early as possible in such women. In cases who intends to continue the pregnancy,closely observation must be provided to ensure the safety for both mother and the fetus.