摘要
目的探讨妊娠合并主动脉夹层患者的临床特征和妊娠结局。方法回顾性纳入2012年1月至2023年10月于首都医科大学附属北京安贞医院妇产科或心外科住院且于本院终止妊娠的妊娠合并主动脉夹层患者的临床资料,根据主动脉夹层的类型分为A型和B型两组。通过查阅医院电子病案系统中患者的临床资料,对其临床特征和妊娠结局进行分析。结果54例妊娠合并主动脉夹层患者中,A型34例(63%)、B型20例(37%),大部分发生在孕晚期且合并主动脉扩张。妊娠合并主动脉夹层高发于年龄<35岁女性。不同类型妊娠合并主动脉夹层患者的心功能分级比较,差异有统计学意义(P<0.05)。85.19%(46/54)的妊娠合并主动脉夹层患者出现临床症状,以胸背部疼痛为主。54例患者中流产20例(37.04%)、早产24例(44.44%)、足月产9例(16.67%),其中发生胎死宫内7例、新生儿窒息12例、低出生体重儿16例。54例患者中剖宫产术或剖宫取胎术终止妊娠46例,接受心脏外科手术治疗42例,其中27例(A型25例、B型2例)为产科和心脏外科联合手术。结论妊娠合并主动脉夹层母胎并发症发生风险高,需要妊娠-心脏多学科团队共同管理。
Objective To discuss the clinical characteristics and pregnancy outcome in patients with aortic dissection during pregnancy.Methods The clinical materials were retrospectively collected in patients with pregnancy-related aortic dissection undergone termination of pregnancy in Department of Obstetrics and Gynecology or Department of Heart Surgery in Beijing Anzhen Hospital affiliated to Capital Medical University from Jan.2012 to Oct.2023.All patients were divided,according to types of aortic dissection,into type A group and type B group.The clinical characteristics and pregnancy outcome were analyzed through consulting clinical materials in electronic medical record system.Results Among 54 patients with pregnancy-related aortic dissection,there were 34(63%)in type A group and 20(37%)in type B group,and aortic dissection occurred mainly in the third trimester and most patients were complicated by aortectasia.The pregnancy-related aortic dissection was common in women aged under 35 years old.The difference in heart function classification had statistical significance between 2 groups(P<0.05).The patients with clinical symptoms,mainly chest and back pain,accounted for 85.19%(46/54).Among 54 patients,there were 20(37.04%)with miscarriages,24(44.44%)with preterm births,9(16.67%)with full-term births,including 7 with intrauterine death,12 with neonatal asphyxia and 16 with low birth weight infants.Among 54 patients,46 received cesarean section or hysterotomy for terminating pregnancy,42 received cardiac surgery,including 27(25 in type A group,2 in type B group)received obstetric surgery combined with cardiac surgery.Conclusion The risk of pregnancy-related aortic dissection is higher,which needs a co-management by multi-disciplinary team.
作者
张豪锋
梁晓君
杨冬
张大伟
林运
李志忠
乔志钰
张军
Zhang Haofeng;Liang Xiaojun;Yang Dong;Zhang Dawei;Lin Yun;Li Zhizhong;Qiao Zhiyu;Zhang Jun(Department of Obstetrics and Gynecology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;不详)
出处
《中国循证心血管医学杂志》
2024年第1期88-92,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
主动脉夹层
妊娠
妊娠结局
Aortic dissection
Pregnancy
Pregnancy outcome
