Background Pregnancy complicating pulmonary arterial hypertension （PAH） is a life-threatening obstetrical complication. Few studies have reported the clinical characteristics and outcomes of pregnant women with PAH....Background Pregnancy complicating pulmonary arterial hypertension （PAH） is a life-threatening obstetrical complication. Few studies have reported the clinical characteristics and outcomes of pregnant women with PAH. Methods Retrospectively analysis was conducted on 86 cases of pregnant women with PAH at the Department of Obstetric in Guangdong General Hospital between 2009 and 2014. Data included patients＇ age, the etiologies of PAH, clinical classification of the New York Heart Association （NYHA）, gestational weeks, delivery mode, maternal and fetal outcomes. Results （1）There were 2 cases of idiopathic pulmonary arterial hypertension （IPAH） and 84 cases of secondary pulmonary arterial hypertension. The latter was composed by 40（47.61%） cases of congenital heart disease （CHD）, 38（45.23%） cases of rheumatic heart disease （RHD）, 3 （3.57%） cases of systemic lupus erythematosus （SLE） and 1 （1.19%） case of partial hydatidiform mole. The number of patients classified in NYHA I-IV were 8 （9.30%）, 41 （47.67%）, 26 （30.23%） and 11 （12.7%）, respectively. And the mortality was 3.48% （3/86）. （2）Among the 86 patients, 31 （36.04%） women gave birth at term and 36（41.86%） had premature delivery. In addition, 16（18.6%） women had an abortion less than 28 weeks. There were a total of 65 （75.58%） live births, 61（93.84%） of whom were delivered via cesarean section, while the other 4 （6.15%） were vaginal deliveries. （3） Patients were divided into 3 groups, 12 of mild （ 〈 40 mmHg）, 35 of moderate （40-70 mmHg） and 39 of severe （≥70 mmHg） regarding the pulmonary artery systolic pressure （sPAP） measured by ultrasound. We defined the former two as group A and the latter as group B. The significance was seen statistically in gestational weeks （32.86 ±8.86 g vs 28.76 ±9.84）, the rate of transferring to ICU （19.14% vs 53.84%）, neonatal birth-weight （2725.69 ±467.43 vs 2044.82 ±665.75 g）, APGAR scoring （9.97 ±0.16 vs 8.68 ± 2.08）, maternal status of heart function and adverse pregnant outcomes, when compared group A with B. All the P-values mentioned above were less than 0.05. Conclusions The rate of various pregnant outcomes increases gradually with the severity of the pulmonary arterial hypertension. Cesarean section may be an appropriate delivery mode and active surveillance that contributes to the improvement of pregnant outcomes.展开更多
Background Pulse oximetry screening（POS） has been proposed as an effective,noninvasive,inexpensive tool allowing earlier diagnosis of critical congenital heart disease（CCHD）.However,most neonates are discharged fr...Background Pulse oximetry screening（POS） has been proposed as an effective,noninvasive,inexpensive tool allowing earlier diagnosis of critical congenital heart disease（CCHD）.However,most neonates are discharged from the hospital without this evaluation in China.This study aimed at assessing the feasibility of POS for newborns in detecting CCHD in the department of obstetrics and neonatal intensive care unit（NICU）.Methods POS was performed in 355 neonates born in the department of obstetrics or admitted to the NICU between January 2015 and June 2015.These neonates were divided into normal group,mild congenital heart disease group（MCHD） and CCHD group,according to the result of echocardiography or computerized tomography（CT）.The gestational age,birth weight and arterial oxygen saturation（SpO_2） were compared among the three groups.The SpO_2 value and diagnosis time of the CCHD cases were classified and analyzed.Results The premature birth and low birth weight were the high risk factors of mild congenital heart disease.There was no difference（P 〉 0.05） in SpO_2 between the MCHD group and the normal group.Significant difference in the SpO_2 appeared between the CCHD group and the normal group（P 〈 0.05）.Combination of POS and clinical examination can reduce the missing diagnosis rate in screening for CCHD.Conclusions POS incurs very low cost and risk of harm and is not required for special training,therefore,an effective way to identify CCHD in neonates.展开更多
文摘Background Pregnancy complicating pulmonary arterial hypertension （PAH） is a life-threatening obstetrical complication. Few studies have reported the clinical characteristics and outcomes of pregnant women with PAH. Methods Retrospectively analysis was conducted on 86 cases of pregnant women with PAH at the Department of Obstetric in Guangdong General Hospital between 2009 and 2014. Data included patients＇ age, the etiologies of PAH, clinical classification of the New York Heart Association （NYHA）, gestational weeks, delivery mode, maternal and fetal outcomes. Results （1）There were 2 cases of idiopathic pulmonary arterial hypertension （IPAH） and 84 cases of secondary pulmonary arterial hypertension. The latter was composed by 40（47.61%） cases of congenital heart disease （CHD）, 38（45.23%） cases of rheumatic heart disease （RHD）, 3 （3.57%） cases of systemic lupus erythematosus （SLE） and 1 （1.19%） case of partial hydatidiform mole. The number of patients classified in NYHA I-IV were 8 （9.30%）, 41 （47.67%）, 26 （30.23%） and 11 （12.7%）, respectively. And the mortality was 3.48% （3/86）. （2）Among the 86 patients, 31 （36.04%） women gave birth at term and 36（41.86%） had premature delivery. In addition, 16（18.6%） women had an abortion less than 28 weeks. There were a total of 65 （75.58%） live births, 61（93.84%） of whom were delivered via cesarean section, while the other 4 （6.15%） were vaginal deliveries. （3） Patients were divided into 3 groups, 12 of mild （ 〈 40 mmHg）, 35 of moderate （40-70 mmHg） and 39 of severe （≥70 mmHg） regarding the pulmonary artery systolic pressure （sPAP） measured by ultrasound. We defined the former two as group A and the latter as group B. The significance was seen statistically in gestational weeks （32.86 ±8.86 g vs 28.76 ±9.84）, the rate of transferring to ICU （19.14% vs 53.84%）, neonatal birth-weight （2725.69 ±467.43 vs 2044.82 ±665.75 g）, APGAR scoring （9.97 ±0.16 vs 8.68 ± 2.08）, maternal status of heart function and adverse pregnant outcomes, when compared group A with B. All the P-values mentioned above were less than 0.05. Conclusions The rate of various pregnant outcomes increases gradually with the severity of the pulmonary arterial hypertension. Cesarean section may be an appropriate delivery mode and active surveillance that contributes to the improvement of pregnant outcomes.
文摘Background Pulse oximetry screening（POS） has been proposed as an effective,noninvasive,inexpensive tool allowing earlier diagnosis of critical congenital heart disease（CCHD）.However,most neonates are discharged from the hospital without this evaluation in China.This study aimed at assessing the feasibility of POS for newborns in detecting CCHD in the department of obstetrics and neonatal intensive care unit（NICU）.Methods POS was performed in 355 neonates born in the department of obstetrics or admitted to the NICU between January 2015 and June 2015.These neonates were divided into normal group,mild congenital heart disease group（MCHD） and CCHD group,according to the result of echocardiography or computerized tomography（CT）.The gestational age,birth weight and arterial oxygen saturation（SpO_2） were compared among the three groups.The SpO_2 value and diagnosis time of the CCHD cases were classified and analyzed.Results The premature birth and low birth weight were the high risk factors of mild congenital heart disease.There was no difference（P 〉 0.05） in SpO_2 between the MCHD group and the normal group.Significant difference in the SpO_2 appeared between the CCHD group and the normal group（P 〈 0.05）.Combination of POS and clinical examination can reduce the missing diagnosis rate in screening for CCHD.Conclusions POS incurs very low cost and risk of harm and is not required for special training,therefore,an effective way to identify CCHD in neonates.
