Sigel Carlie S, Harper Teresa C, Thorne Leigh B
Department of Pathology, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599-7525, USA.
Obstet Gynecol. 2007 Aug;110(2 Pt 2):501-3. doi: 10.1097/01.AOG.0000263462.26082.f0.
Pulmonary arterial hypertension carries a high maternal mortality rate in the peripartum period. Pulmonary hypertension may arise as a complication of portal hypertension with poor patient survival.
A young primigravida with chronic autoimmune hepatitis and portal hypertension presented at 26 4/7 weeks of gestation with contractions and bleeding. Within 48 hours, an 892-g female fetus was delivered vaginally without complications. On postpartum day 2, the mother was found on the floor by her bed. Although initially responsive, within minutes she was unresponsive and resuscitation was unsuccessful. Postmortem examination showed cirrhosis and plexogenic pulmonary arteriopathy.
Increased awareness of pulmonary hypertension as a complication of portal hypertension and a high index of clinical suspicion are necessary to diagnose pregnant women with this condition and provide appropriate prenatal counseling and peripartum intervention.
肺动脉高压在围产期产妇死亡率很高。肺动脉高压可能作为门脉高压的并发症出现，患者生存率低。
一名患有慢性自身免疫性肝炎和门脉高压的初产妇在妊娠26 4/7周时出现宫缩和出血。48小时内，经阴道分娩出一名体重892克的女婴，无并发症。产后第2天，母亲被发现倒在床边的地板上。虽然最初有反应，但几分钟内就失去了反应，复苏未成功。尸检显示肝硬化和丛状肺血管病。
提高对肺动脉高压作为门脉高压并发症的认识以及高度的临床怀疑指数，对于诊断患有这种疾病的孕妇并提供适当的产前咨询和围产期干预是必要的。
