摘要
目的探讨妊娠合并肺动脉高压患者的妊娠结局。方法回顾性分析2007年1月—2010年8月我院产科收治的31例妊娠合并肺动脉高压患者的临床资料,按照肺动脉收缩压高低分为轻度肺动脉高压（30~49 mmHg）、中度肺动脉高压（50~79 mm Hg）和重度肺动脉高压（≥80 mm Hg）,分析患者的心脏病类型,心功能级别,终止妊娠的时间、方式以及母儿结局。结果 （1）不同程度肺动脉高压患者心功能分级比较,差异有统计学意义（P〈0.01）。（2）31例肺动脉高压患者中,足月分娩9例（29.0%）,早产10例（32.3%）,医源性流产12例（38.7%）。新生儿死亡1例。（3）31例患者中,27例（87.1%）患者行剖宫产或剖宫取胎术。（4）妊娠合并肺动脉高压患者死亡6例,病死率为19.4%,均为妊娠合并中重度肺动脉高压患者。结论 （1）重度肺动脉高压患者不宜妊娠,轻、中度肺动脉高压患者孕前应请专科医师综合评估以确定是否适合妊娠。（2）妊娠合并肺动脉高压患者的医源性早产率和胎儿丢失率较高。（3）剖宫产或剖宫取胎术是比较安全的终止妊娠方式。
Objective To explore the pregnancy outcomes of women with pulmonary hypertension.Methods A total of 31 cases of pregnancy with pulmonary hypertension treated at our facility fromJanuary 2007 to August 2010 were retrospectively reviewed and divided into three groups according to the systolic pressure of the pulmonarty artery： mild（30～49 mm Hg）,moderate（50～79 mm Hg）and severe（≥80 mm Hg）.The types of heart diseases,cardiac functional classification（New York heart association,NYHA）,time point and form of pregnancy termination and outcomes of the infants and the mothers were analyzed.Results（1）Cardiac functional classification among different degrees of pulmonary hypertension showed significant differences（P0.01）.（2） The outcomes of the 31 cases were：term delivery in 9 cases（29.0%）,preterm labor in 10 cases（32.3%）,iatrogenic abortion in 12 cases（38.7%） and neoborn death in 1 case.（3）Twenty-seven（87.1%） out of the 31 patients underwent caesarean section.（4） Six out of those patients with moderate-to-severe pulmonary hypertension died（a mortality rate of 19.4%）.Conclusion（1） Patients with severe pulmonary hypertension are unsuitable for pregnancy while patients with with mild-to-moderate pulmonary hypertension should consult a specialist before pregnancy.（2） The rates of iatrogenic preterm labor and iatrogenic abortion are higher among women with pulmonary hypertension.（3） Caesarean section is a relatively safe way for pregnancy termination in patients with pulmonary hypertension.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第21期2441-2442,2445,共3页
Chinese General Practice
基金
北京市卫生局十百千人才项目基金(200909)
关键词
妊娠并发症
肺动脉高压
妊娠结局
Pregnancy complication
Pulmonary hypertension
Pregnancy outcome
