妊娠合并先天性心脏病93例临床分析

目的:探讨妊娠合并先天性心脏病(先心病)患者孕期的合理监护、处理,以减少母儿发病率及死亡率。方法:回顾性分析10年间93例妊娠合并先心病者的妊娠结局。结果:①先心病以房间隔缺损、室间隔缺损为主,占56%,先心病手术以修补术为主,占69.4%。心功能Ⅰ-Ⅱ级者80例(占86%),Ⅲ~Ⅳ级者13例(占14%)。②心功能Ⅲ-Ⅳ级者较心功能Ⅰ~Ⅱ级者早产儿、小于孕龄儿的发生率高,新生儿平均体重低,有显著差异。2例孕产妇死亡均发生于心功能Ⅳ级者。③手术后妊娠可改善心功能,减少继发性肺动脉高压的发生,提高新生儿的体重。结论:妊娠合并先心病以间隔缺损为主,无论何种先心病,发现后宜尽早手术,术后再妊娠,可降低母儿发病率及死亡率。孕期尽可能维持心功能Ⅰ~Ⅱ级,减少并发症的发生,可望安全渡过孕期;心功能不良导致母儿预后不良。

Rctrospective analysis of 93 cases of pregnant women complicated with congenital heart disease

Objective:To investigate the monitoring and treatment of pregnant women with CHI),to reduce the mortality and morbidity of both mother and fetus.Methods:Clinical data of 93 cases of pregnant women with CHD in ten years were analyzed retrospectively.Results:①The highest incidence of CHD were atrial septal defect and ventricular septal defect(56%),septopexy was the most common surgery(69.4%).Pregnant women with grade I-II heart function were 80 cases(86%),grade III-IV heart function were 13 cases(14%);② The incidence of premature delivery,SGA and average of lower weight of newborns were higher in women with grade III-IV heart function.Two cases maternal death occurred in the women with grade IV heart function.Conclusion:It was better for both maternal and fetus outcome after operation on those complicated by CHD,which could reduce their morbidity.