摘要
目的 探讨妊娠合并心脏病患者不同心功能状态对母亲和围产儿的影响。方法 对我院 1993年 1月至 1999年 3月间 ,2 6 6例妊娠合并心脏病患者的临床资料进行回顾性分析。结果 ( 1)妊娠合并心脏病患者以心肌炎、心肌炎后遗症及不明原因性心律失常的发生率最高 ( 179例 ,6 7.2 9% ) ,其次为先天性心脏病 ( 41例 ,15 .41% ) ,其发生率高于风湿性心脏病 ( 2 8例 ,10 .91% )。( 2 )风湿性心脏病和先天性心脏病是导致心功能异常的主要病因 ,紫绀型心脏病 ,二尖瓣狭窄和风湿性或先天性心脏病合并肺动脉高压者更易发生心功能衰竭。心功能衰竭好发期为孕 33周。心脏手术者心功能I～II级占 95 .45 %。( 3)心功能III～IV级者 ,其早产儿、新生儿低体重和围产儿死亡等发生率明显增加。结论 妊娠合并心肌炎 ,心肌炎后遗症及不明原因心律失常的发生率有升高趋势。风湿性和先天性心脏病仍是导致孕产妇严重心功能不良的主要病因 ,及时药物治疗和终止妊娠可降低孕产妇死亡率 ;心脏手术能明显改善心功能 ,使妊娠有良好结局。
Objective To investigate the influence of cardiac function of pregnant women on outcome of their pregnancies. Methods Clinical data of 266 cases of pregnant women with heart diseases from January, 1993 to March, 1999 were analyzed retrospectively. Results (1) The highest incidence of cardiac disease with grade I to II of heart function was due to myocarditis, sequelae of myocarditis and abnormal cardiac rhythm (179 cases, 67.29%). The incidence of congenital heart disease is on the second (41 cases, 15.41%) which is higher than that of rheumatic heart disease (28 cases, 10.91%). (2) Grade III and IV cardiac function was mainly related to congenital and rheumatic heart diseases during pregnancy. The rate of grade I/II heart function in pregnant women after heart operations was 95.45%. (3) The incidence of premature delivery, low weight of newborns and perinatal mortality of mother were higher in women with grade III and IV heart function than in those with grade I and II heart function. Conclusions The incidence of myocarditis and sequelae of myocarditis is increasing. Pregnancies complicated with congenital and rheumatic heart diseases are still major causes of perinatal morbidity and mortality of mother and baby. Heart operation can obviously improve the heart function. More effective managements should be adopted.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2000年第6期338-341,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
心脏病
妊娠结局
妊娠合并症
Pregnancy complications, cardiovascular
Heart diseases
Pregnancy outcome
