Schmaltz A A, Neudorf U, Winkler U H
Abteilung für Pädiatrische Kardiologie, Zentrum für Kinder- und Jugendmedizin und Zentrum für Frauenheilkunde, Universität-GH-Essen.
Z Geburtshilfe Neonatol. 1999 May-Jun;203(3):101-9.
The improved pediatric-cardiological diagnostics and cardio-surgical therapy result in a numerical increase of women reaching reproductive age. Pregnancy considerably strains heart and circulation, which is countered by various cardiorespiratory mechanisms. Today mothers are not endangered vitally (exception: Eisenmenger-syndrome), but congestive heart failure, thromboembolic complications and rhythm disturbances may occur. Spontaneous abortion rate is 20-25%, prematurity and underweight are obligatory in cyanotic mothers. On the basis of an extensive review of literature the specific risks during pregnancy are discussed taking into account the hemodynamic situations in different heart defects. Anticoagulation of valve prosthesis depends upon the model and location of the prosthesis. Contraceptive counselling is deficient; it has to consider the risk of thromboembolic complications. Regarding the genetic risk we have to differentiate between each single defect and between the sex of the parents.
儿科心脏病诊断和心脏外科治疗的改进使得达到生育年龄的女性数量有所增加。怀孕会给心脏和循环系统带来相当大的负担，而各种心肺机制会对此起到应对作用。如今，母亲的生命一般不会受到威胁（艾森曼格综合征除外），但可能会出现充血性心力衰竭、血栓栓塞并发症和心律失常。自然流产率为20% - 25%，发绀型母亲所生婴儿必然会出现早产和体重不足的情况。在广泛查阅文献的基础上，结合不同心脏缺陷的血液动力学情况，讨论了孕期的特定风险。人工瓣膜的抗凝治疗取决于瓣膜的型号和位置。避孕咨询存在不足；必须考虑血栓栓塞并发症的风险。关于遗传风险，我们必须区分每一种单一缺陷以及父母的性别。
