摘要
目的：探讨妊娠合并先天性心脏病的类型以及心脏矫正手术对母婴结局的影响。方法：回顾性分析53例于2010年3月-2014年2月就诊的妊娠合并先天性心脏病孕妇及胎儿的临床资料。结果：先心病排名前三位的是房间隔缺损16例（占29.6%）,室间隔缺损15例（占28.3%）和动脉导管未闭14例（占26.4%）。调查发现,心功能Ⅲ-Ⅳ级患者（占41.7%）较心功能Ⅰ-Ⅱ级患者（占82.3%）有较高的剖宫产率（P〈0.05）。心功能Ⅰ-Ⅱ级的妊娠合并先心病患者的母婴并发症显著少于心功能Ⅲ-Ⅳ级的患者（P〈0.05）：心功能Ⅲ-Ⅳ级的先心病产妇的心衰及死亡发生率显著增高（P〈0.05）,胎儿生长受限、早产、子代先心病及围产儿死亡率明显增高（P〈0.05）。53例中,有19例分娩前进行了心脏矫正手术（占35.8%）。手术组的剖宫产率55.9%,未手术组剖宫产率为47.4%,两者剖宫产率比较无统计学差异（P〉0.05）。在手术组中,先心病产妇在妊娠及分娩期无心衰和死亡出现,且未出现新生儿FGR或死亡。与未进行心脏手术比较,其母婴并发症的发生率明显降低（P〈0.05）。结论：对于妊娠合并先心病的患者,其母婴结局与心脏的功能状况密切相关,因此一旦确诊,应尽早手术治疗,经过心脏矫正手术后心功能良好的产妇,可获得较理想的母婴结局。
Objective： To explore the effects of pregnancy cOmbined with different types of congenital heart diseases and heart corrective procedure on maternal and infantile outcomes. Methods： The clinical data of 53 pregnant women and fetuses with congenital heart diseases who went to the hospital from March 2010 to February 2014 were analyzed retrospectively. Results： The top three types of congenital heart diseases were atrial septal defect （16 cases, accounting for 29.6% ）, ventricular septal defect （15 cases, accounting for 28. 3% ）, and patent ductus arteriosus （ 14 cases, accounting for 26. 4% ） . The rate of cesarean section among the cases of cardiac function class Ill- IV （ accounting for 41.7% ） was statistically significantly higher than that among the cases of cardiac function class I - II （ accounting for 82. 3% ） （P〈0.05） . The incidence rates of maternal and infantile complications among the cases with pregnancy combined with congenital heart diseases of cardiac function class I - II were statistically significantly less than those among the cases of cardiac function class III-IV （ P〈0. 05 ） ： the incidence rate of heart failure and maternal mortality among the cases of cardiac function class III - IV increased significantly （P〈0. 05）, the incidence rates of fetal growth restriction （FGR）, premature birth, congenital heart diseases among the infants, and perinatal mortality increased significantly （P〈0. 05） . Among 53 cases, 19 cases underwent heart corrective procedure before delivery, accounting for 35.8%. The rates of cesarean section in operation group and non-operation group were 55.9% and 47.4%, respectively, there was no statistically significant difference between the two groups （P〉0. 05） . In operation group, heart failure and maternal death did not occur among the cases during pregnancy and delivery; no FGR and neonatal death occurred. Compared with non-operation group, the incidence rates of maternal and infantile complications in operation group decreased significantly （ P〈0.05 ） . Conclusion： For the patients with pregnancy combined with congenital heart diseases, maternal and infantile outcomes are closely correlated with heart function and status; thus, operation should be performed as soon as possible after diagnosis, the cases with good heart function after heart corrective procedure can obtain good maternal and infantile outcomes.
出处
《中国妇幼保健》
CAS
2015年第13期1994-1996,共3页
Maternal and Child Health Care of China
关键词
妊娠
先天性心脏病
母婴结局
Pregnancy
Congenital heart disease
Maternal and infantile outcomes
