先天性心脏病术后对妊娠结局的影响

目的探讨妊娠合并先天性心脏病手术后对妊娠结局的影响。方法回顾性分析50例妊娠合并先天性心脏病患者的临床资料。结果①妊娠合并先天性心脏病患者以房间隔缺损和室间隔缺损为主，占48．0％（24／50）。②手术组与未手术组比较，心功能Ⅲ～Ⅳ级与肺动脉高压的发生率降低（P〈0．05）；3例心力衰竭均发生在未手术组，死亡1例；手术组无早产与围产儿死亡，而未手术组早产4例（26．7％），1例死亡。③妊娠合并先天性心脏病分娩方式以剖宫产为主（72．0％），手术组与未手术组比较，差异无统计学意义（P〉0．05）。结论妊娠合并先天性心脏病确诊后宜尽早手术治疗，术后可降低母儿的发病率及死亡率；剖宫产终止妊娠是比较安全的分娩方式。

Effect of postoperative congenital heart disease on pregnancy outcome

Objective To evaluate the effect of postoperative congenital heart disease（CHD） on pregnancy outcome. Methods A retrospective study was conducted to review clinical data of 50 cases of pregnancy complicated with CHD from 2003 - 2010. Results （1）CHD was the most common disease among pregnant women complicated with cardiac diseases （56%）, mainly with atrial septal defect and ventricular septal defect （42%）. （2）The incidence of grade Ⅲ～Ⅳ heart function and pulmonary hypertension of the operated group was lower than that of the non - operated group that the difference was significant（P 〈0. 05）. The results showed 3 cases of heart failure, 1 case of mother death, 4 cases of premature birth, 1 case of prenatal infant death in the non - operated group. （3）Caesarean section rate was 78% among all patients and the difference of caesarean section between the operated group and the nonoperated group was no significant（ P 〉 0.05 ）. Conclusion Surgery should be indicated for pregnant patients complicated with CHD which can improve the pregnancy outcome and reduce the morbidity. Caesarean section is the better choice of safe delivery for pregnant patients complicated with CHD.