Management of Pregnancy with Ankylosing Spondylitis

Objective To discuss the interaction between pregnancy and ankylosing spondylitis, and the management of pregnancy with ankylosing spondylitis. Methods Twelve cases of pregnancy with ankylosing spondylitis in Peking Union Medical College Hospital from September 2004 to July 2011 were analyzed retrospectively, focusing on the arteritis condition, pregnancy complications, and outcomes. Results All the 12 patients had full-term pregnancy. Five cases gave birth naturally, and 7 cases received cesarean section for maternity factors. No adverse pregnancy outcomes were encountered. Waist pain appeared in 2 cases in the second trimester, for both of which medication failed. One of the 2 cases had natural childbirth, while the other maintained pregnancy smoothly to cesarean section. Conclusions Pregnancy monitoring can help obtain favorable pregnancy outcomes. Attention should be paid to postpartum change of the illness.

妊娠合并心衰的处理和分娩方式的选择

总结４６例妊娠合并心衰的临床处理与分娩方式和时机的选择。对合并急、慢性心衰的病例选用以血管扩张剂和强心利尿剂综合治疗控制心衰，２４小时心衰控制率达８２．６１％。３９例在连续硬膜外麻醉下行剖宫产终止妊娠，其中５例在心衰不能得到有效控制时行紧急剖宫产术抢救母婴生命，剖宫产母婴均获存活；７例经阴道分娩，其中２例新生儿死亡。结论：对妊娠合并心衰的孕妇选用血管扩张剂和强心、利尿剂综合治疗能获得良好的临床效果，在连续硬膜外麻醉下行剖宫产术终止妊娠对心衰已控制或未控制者都是抢救母婴生命的有效措施。