心功能衰竭孕妇的分娩处理策略

目的 探究妊娠晚期合并心功能衰竭患者的分娩期处理策略.方法 回顾性分析2007年12月至2018年12月间我院心脏外科与妇产科联合治疗的23例妊娠晚期合并心功能衰竭(心功能Ⅲ～Ⅳ级)患者的临床资料,探讨心功能衰竭孕妇的分娩处理及临床急救策略.结果 23例孕妇均以全身麻醉剖宫产术作为结束妊娠的方式.17例患者单纯行剖宫产...

Management strategy of pregnant women with heart failure during delivery

Objective:To explore the management strategy of pregnant patients with heart failure during delivery.Methods:The data of 23 patients with late pregnancy complicated with cardiac failure(cardiac function gradeⅢ-Ⅳ)were retrospectively analyzed.The patients were treated by cardiac surgery and obstetrics and gynecology from December 2007 to December 2018,in order to explore the delivery management and clinical emergency strategy of pregnant women with heart failure.Results:Cesarean section under general anesthesia was used to end pregnancy in 23 pregnant women.Seventeen patients underwent caesarean section alone and passed the perinatal period smoothly,and they underwent cardiac surgery or medical treatment after the perinatal period.Cardiac arrest or ventricular fibrillation occurred in six patients during cesarean section,and emergency femoral arteriovenous puncture was performed to establish V-A ECMO.Among the six patients,two patients recovered spontaneous heart rhythm within 2 hours after V-A ECMO,and one patient had heart beat spontaneously 6 hours after V-A ECMO.Although spontaneous rhythm recovered,ventricular fibrillation occurred repeatedly in three patients,and two of them underwent cardiac valve replacement and ventricular septal occlusion respectively on the third day after cesarean section.One of the three patients died of pulmonary infection 12 days after cardiopulmonary bypass because of severe cardiomyopathy.Conclusions:Heart failure in late pregnancy is one of the main causes of maternal death.Strengthening pregnancy care and multidisciplinary consultation,and timely termination of pregnancy can improve the prognosis of patients with heart failure.