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Sixty-one cases of severe heart diseases were treated between Jan. 1977 and Dec. 1986, accounting for 18.37% of the heart diseases in pregnancy. Of these 61 cases, 39 (63.93%) underwent cesarean section under continuous lumbar epidural anesthesia. The systolic/diastolic blood pressure and mean arterial pressure (MAP) values decreased from the beginning of anesthesia to the end of delivery, and then the values gradually went up to the preoperative level. During the operation, no heart failure occurred. In 22 cases (36.07%), when labor began, the systolic/diastolic pressure and MAP increased and attained the peak value during parturition. After the fetus was delivered, the blood pressure decreased immediately. In 10 cases, heart failure occurred during labor. The adjusted mortality was 4.92%. Two patients died after vaginal delivery. Of these, one had heart failure during labor and underwent cesarean section, but she died after the operation. It was noted that hemodynamic change during cesarean section was smaller than that during vaginal delivery. If an appropriate time is selected for termination of pregnancy or cesarean section is only performed in the early stage of labor, heart failure and fatal outcome may be avoided. 相似文献
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