82例妊娠合并肺动脉高压孕妇的临床分析

Clinical Analysis in 82 Pregnant Women with the Severity of Pulmonary Hypertension

目的:探讨妊娠合并不同程度肺动脉高压(PAH)患者的临床特点和妊娠结局。方法:回顾性分析青岛大学附属医院崂山院区产科2020年1月至2023年1月收治的82例妊娠合并肺动脉高压患者的临床资料。根据PAH严重程度分为:轻度PAH (30~49 mmHg)、中度PAH (50~79 mmHg)、重度PAH (≥80 mmHg),比较各组PAH孕妇的分娩时机、方式和母婴结局。结果:1) 合并轻、中、重度PAH各组患者年龄、平均住院时间比较无统计学差异(p > 0.05),轻度PAH组孕妇平均分娩孕周大于中、重度PAH组(p 0.05),PAH患者行剖宫产手术时椎管内麻醉率大于全身麻醉率(p > 0.05)。3) 合并、中、重度PAH各组患者产后出血量无统计学差异(p > 0.05);术后转重症监护室(ICU)率和术后心衰发生率及新生儿低体重率具有统计学差异(p 0.05);新生儿低体重率具有统计学差异(p < 0.05)。结论:妊娠合并PAH严重威胁母婴安全,孕期规律、全程产检和适时终止妊娠对改善妊娠结局有关键作用。

0bjective: To investigate clinical characteristics and pregnancy outcomes of pregnant patients with pulmonary arterial hypertension (PAH). Methods: A retrospective study was conducted on 82 cases of pregnant women complicated with pulmonary hypertension who delivered in the Affiliated Hos-pital of Qingdao University from 2020.1 to 2023.1. The cases were divided into three groups ac-cording to the severity of pulmonary hypertension: mild PAH group (30~49 mmHg), moderate PAH group (50~79 mmHg), severe PAH group (≥80mmHg). The timing of delivery, mode of delivery and pregnancy outcomes were compared between these three groups. Results: 1) There was no signifi-cant difference in the average age and timing in the hospital of mild, moderate and severe PAH group (p > 0.05). Gestational age of mild PAH group was later than the other two groups (p 0.05). The rate of neuraxial anesthesia was more than that of general anaesthetic when cesarean section was conducted in these three groups (p > 0.05). 3) The postpartum hemorrhage of patients with the severity of PAH was similar in these three groups (p > 0.05). But the rates of admission of intensive care unit (ICU) and postoperative heart failure were significantly different in three groups (p 0.05). But the rate of neonatal low weight was significantly different in three groups (p < 0.05). Con-clusions: Pregnancy complicated with PAH is a severe threat to maternal and fetal health. Regular and full-course prenatal examinations during pregnancy and timely termination of pregnancy can enhance the outcomes of pregnancy.