妊娠合并肺动脉高压23例分析

目的 探讨合并肺动脉高压(PH)妇女能否妊娠及妊娠的适宜时间。方法 回顾性分析1997～2002年在我院诊治的23例合并有PH的孕妇，分析PH的分类，妊娠结局。结果 3例合并原发性肺动脉高压(PPH)孕妇，2例在剖宫产术中死亡，1例在孕早期终止妊娠后存活。14例因合并风湿性心脏病(风心病)致PH的孕妇，妊娠至足月行剖宫产者10例，1例早产，3例引产，无一例孕妇死亡。6例因合并先天性心脏病(先心痛)致PH的孕妇，轻度PH孕妇3例，均妊娠至足月；重度PH孕妇3例，2例死亡，1例存活。结论 PPH患者应避免妊娠。风心病致PH的孕妇，依心功能、PH高低及血氧饱和度决定是否终止妊娠。对先心病致PH者，最好在手术或药物治疗后妊娠；患Eisenrnenger’s综合征妇女禁止妊娠。

Pulmonary hypertension in pregnancy:analysis of 23 cases

ObjectiveTo study whether the women with pulmonary hyp er tension(PH) can tolerate pregnancy or not and the proper time for their pregnanc ies.MethodsThe data of 23 cases with PH treated in our hospital during 1997 to 2002 were retrospectively analyzed,including the types of PH and the ou tcomes.ResultsOf 3 pregnant women with primary pulmonary hypertension(PPH ) ,2 died during cesarean section and 1 survived after early termination of pregna ncy;of 14 pregnancy complicated by PH induced by rheumatic disease,10 received c esarean section at full-term of pregnancy,3 induced labor and 1 pre-term labor,a ll survived;of 6 pregnancy complicated with PH induced by congenital heart disea se,3 mild cases had full-term pregnancy and of the rest 3 severe cases,2 died an d 1 survived.ConclusionPatients with PPH should avoid pregnancy.Whether the pat ient with secondary PH caused by rheumatic heart disease can tolerate the pregna ncy or not should be decided by cardiac function,PH degree and SaO\-2 value.For PH induced by congen ital heart disease,surgical or medical therapy should be given before pregnancy. Women with Eisenmenger syndrome should avoid pregnancy.