妊娠合并心房颤动的诊治

目的:探讨妊娠合并心房颤动对母儿的影响及诊治方法。方法:回顾分析1998年1月至2006年6月上海仁济医院诊治的13例妊娠合并心房颤动的临床资料。结果:妊娠合并心房颤动患者多有器质性心脏病,其中风湿性心脏病是主要病因(76.92%);妊娠合并心房颤动且有器质性心脏病患者心功能Ⅲ~Ⅳ级发生率明显高于无器质性心脏病者(80%vs0%,P<0.05);医源性胎儿丢失率23.08%(3/13),早产发生率23.08%(3/13)。结论:患器质性心脏病的孕妇合并心房颤动易致母亲心功能恶化,应动态监测心功能,及时处理。为母亲安全,宜适时引产或行剖宫产术终止妊娠。

The diagnosis and treatment of pregnancy complicated with atrial fibrillation

Objective:To explore the influence of atrial fibrillation on mother and fetus during pregnancy in order to discuss the diagnosis and treatment of pregnancy complicated with atrial fibrillation.Methods:The histories of 13 cases with pregnancy complicated with atrial fibrillation admitted into Renji Hospital from Jan.1998 to June 2006 were analyzed retrospectively.Results:Most pregnant women with atrial fibrillation had organic heart disease and rheumatic heart disease was the main etiological factor(76.92%).The incidence of heart function III-IV in pregnant women with atrial fibrillation and organic heart disease was obviously higher than that in pregnant women without organic heart disease(80% vs 0%,P<0.05).The incidence of iatrogenic loss of fetus was 23.08%(3/13).The incidence of premature delivery was 23.08%(3/13).Conclusion:The heart function is easy to get worse in pregnant women complicated with atrial fibrillation and organic heart disease.The key of treatment is to monitor the heart function of mother at intervals.Considering the safty of mother,induced abortion and Cesarean section at the right moment is more suitable.