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1、中国妇产科临床杂志2010年1月第11卷第1期ChinJClinObstetGynecolJanuary2010,Vol.11,No.1·21··论著·44例妊娠合并先天性心脏病母儿结局临床分析魏俊王雁刘国莉张晓红王山米【摘要】目的探讨孕妇先天性心脏病类型与母儿不良事件的相关性。方法回顾性分析1998年1月至2008年12月北京大学人民医院产科分娩的44例先天性心脏病孕妇及胎儿临床资料。结果孕妇先天性心脏病类型前3位依次为房间隔缺损36.36%(16/44)、动脉导管未闭18.18%(8/44)、室间隔缺损15.91%(7/44)和二尖
2、瓣脱垂15.91%(7/44)。共发生20次不良事件,其中5次为心脏不良事件,15次为产科不良事件。发生不良事件的前3位孕妇先天性心脏病的类型依次为房间隔缺损40%(8/20)、动脉导管未闭20%(4/20)和主动脉瓣狭窄20%(4/20)。产科不良事件中,子痫前期3例,早产4例,胎儿生长受限2例,新生儿需入住NICU3例,新生儿轻度窒息2例,子代先心病1例。结论孕妇先天性心脏病中房间隔缺损合并肺动脉高压可能会增加母儿风险,但大部分母儿结局良好。【关键词】先天性心脏病;妊娠;母儿结局Clinicalanalysisof44pregnan
3、twomencomplicatedwithcongenitalheartdiseaseWEIJun,WANGYan,LIUGuoli,etal.(DepartmentofObstetrics,People'sHospitalPekingUniversity,Beijing100044,China)【Abstract】ObjectiveToinvestigatethematernal-fetaloutcomeofpregnantwomenwithcongenitalheartdisease(CHD).Methods44pregnantwo
4、menwithCHDwhodeliveredinourhospitalfromJanuary,1998toDe-cember,2008wererecruitedinthisstudy.Adversecardiaceventsweredefinedasmaternaldeath,congestiveheartfailure,myocardialinfarction,theneedforurgentcardiacintervention,orarrhythmiarequiringtreatment.Adverseobstetricevent
5、sweredefinedaspretermdelivery,stillbirth,preeclampsia,smallforgestationalage,orneonatalin-tensivecareunitadmission.ResultsThereweretotally45deliveriesinthese44womenwithCHD.Themostpop-ulartypeofCHDwereatrialseptaldefects(16/44,36.36%),patentductusarteriosus(8/44,18.18%),v
6、entric-ulardefects(7/44,15.91%)andmitralvalveprolapsewithregurgitation(7/44,15.91%).Therewere5adversecardiaceventswhichwereallcongestiveheartfailureand15adverseobstetricevents.Theadverseeventswerelikelytooccurinpatientswithatrialseptaldefects(8/20,40%),patentductusarteri
7、osus(4/20,20%)andaorticste-nosis(4/20,20%).Theadverseobstetriceventswere3preeclampsia,4pretermdelivery,2smallforgestationalage,3neonatalintensivecareunitadmission,2neonatalasphyxiaand1neonatewithCHD.ConclusionsPregnan-cyinwomenwithatrialseptaldefectsmayincreaseriskstobot
8、hmothersandfetus.Nonetheless,favorablematernalandneonataloutcomesachievedinthemajoritypatients.【Keyword
