Rosen A, Klein M, Rosen H, Laczkovics A, Rokitansky A, Beck A
Department of Gynecology and Obstetrics, Hanusch Hospital, Vienna, Austria.
Gynecol Obstet Invest. 1992;34(3):184-7. doi: 10.1159/000292756.
Pregnancies following cardiac valve surgery represent a considerable maternal and fetal risk. The present paper is a report of 163 women in child-bearing age who underwent cardiac valve surgery. Congenital (14.7%) and acquired (85.3%) cardiac defects required a total of 72 alloplastic and 16 bioprosthetic valve implantations. In 69 patients, purely instrumental correction was performed, in 6 patients conduits were placed. Thirty-four pregnancies were observed and led to the delivery of 18 healthy infants. The birth weight was always in the 2-sigma normal range or slightly above. Three cesarean sections were performed due to the cardiac defect, in 6 patients vacuum extraction or forceps delivery was done, and in 9 patients delivery was spontaneous. We observed 4 cases of spontaneous abortion, and in 12 cases interruption of pregnancy. 75.1% women never became pregnant. Potential risks in terms of endocarditis, repeated valve implantation and anticoagulation are emphasized, methods to decrease the physical strain during delivery are discussed.
心脏瓣膜手术后的妊娠对母亲和胎儿都构成相当大的风险。本文报告了163名接受心脏瓣膜手术的育龄妇女的情况。先天性（14.7%）和后天性（85.3%）心脏缺陷共需要植入72个异体瓣膜和16个生物瓣膜。69例患者仅进行了器械矫正，6例患者植入了导管。观察到34次妊娠，共分娩出18名健康婴儿。出生体重始终在2倍标准差正常范围内或略高于该范围。因心脏缺陷进行了3次剖宫产，6例患者采用真空吸引或产钳助产，9例患者自然分娩。我们观察到4例自然流产，12例妊娠终止。75.1%的妇女从未怀孕。文中强调了心内膜炎、再次瓣膜植入和抗凝方面的潜在风险，并讨论了减轻分娩时身体负担的方法。
