Bauce Barbara, Daliento Luciano, Frigo Gianfranco, Russo Giulia, Nava Andrea
Division of Cardiology, University of Padua Medical School, Padua, Italy.
Eur J Obstet Gynecol Reprod Biol. 2006 Aug;127(2):186-9. doi: 10.1016/j.ejogrb.2005.10.011. Epub 2005 Dec 7.
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a cardiac disease characterised by myocardial necrosis followed by fibro-fatty substitution leading to the onset of ventricular arrhythmias. The aim of the present study was to analyse pregnancy in women affected by this condition.
Six women affected by ARVC/D who underwent a pregnancy were studied with a follow-up programme, consisting of 12-lead ECG, signal-averaged ECG, 24-h ECG and two-dimensional and Doppler echocardiogram performed before the beginning of the pregnancy, at 3rd and 7th month of gestation and after the delivery.
All women were on antiarrhythmic therapy during pregnancy; two complained of palpitations in the last 3 months. Delivery was performed at full terms in all, with caesarean section and epidural anaesthesia in four. Mean weight at birth was 3490g. No adverse reactions on the newborns were detected. All patients were advised against breast-feeding. No significant morphological changes were detected. During the period following the delivery (1-6years, mean 2,6years) one subject experienced a sustained ventricular tachycardia.
Pregnancy seems to be well tolerated in patients affected by ARVC/D, but a programmed clinical protocol is mandatory particularly in the last trimester and puerperium, due to increased risk of ventricular arrhythmias.
致心律失常性右室心肌病/发育不良（ARVC/D）是一种心脏疾病，其特征为心肌坏死，随后发生纤维脂肪替代，进而导致室性心律失常发作。本研究的目的是分析患此病女性的妊娠情况。
对6例患ARVC/D且经历妊娠的女性进行研究，采用随访方案，包括在妊娠开始前、妊娠第3个月和第7个月以及分娩后进行12导联心电图、信号平均心电图、24小时心电图以及二维和多普勒超声心动图检查。
所有女性在孕期均接受抗心律失常治疗；2例在妊娠最后3个月主诉心悸。所有患者均足月分娩，其中4例行剖宫产及硬膜外麻醉。新生儿平均出生体重为3490克。未检测到对新生儿有不良反应。所有患者均被告知不要母乳喂养。未检测到明显的形态学变化。在分娩后的时期（1 - 6年，平均2.6年），1例患者发生持续性室性心动过速。
患ARVC/D的患者似乎对妊娠耐受性良好，但由于室性心律失常风险增加，制定程序化的临床方案是必要的，尤其是在妊娠晚期和产褥期。
