Kolibash A J, Ruiz D E, Lewis R P
Ann Intern Med. 1975 Jun;82(6):791-4. doi: 10.7326/0003-4819-82-6-791.
The coexistence of pregnancy and idiopathic hypertrophic subaortic stenosis is a potentially dangerous combination. We report a 23-year-old white woman with idiopathic hypertrophic subaortic stenosis and pregnancy who presented with severe symptoms (Class IV) and modest outflow obstruction associated with marked mitral regurgitation. After delivery, the evidence for significant mitral regurgitation regressed, while the outflow obstruction seemed unchanged. However, she returned to Functional Class II. We review the mechanisms by which pregnancy and labor may alter the hemodynamics of idiopathic hypertrophic subaortic stenosis and we discuss recommendations for the management of these patients during pregnancy, labor, and the immediate postpartum period. We conclude that despite increasing symptoms, most women with diopathic hypertrophic subaortic stenosis can tolerate pregnancy and a vaginal delivery.
妊娠与特发性肥厚性主动脉瓣下狭窄并存是一种潜在的危险组合。我们报告了一名23岁患有特发性肥厚性主动脉瓣下狭窄的白人女性，她在孕期出现了严重症状（IV级），伴有中度流出道梗阻及明显的二尖瓣反流。分娩后，明显二尖瓣反流的证据消退，而流出道梗阻似乎未变。然而，她恢复到了心功能II级。我们回顾了妊娠和分娩可能改变特发性肥厚性主动脉瓣下狭窄血流动力学的机制，并讨论了在妊娠、分娩及产后即刻对这些患者的管理建议。我们得出结论，尽管症状加重，但大多数患有特发性肥厚性主动脉瓣下狭窄的女性能够耐受妊娠和阴道分娩。
