Karamermer Yusuf, Roos-Hesselink Jolien W
Erasmus MC, Department of Cardiology, Room Ba308, s-Gravendijkwal 230, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Expert Rev Cardiovasc Ther. 2007 Sep;5(5):859-69. doi: 10.1586/14779072.5.5.859.
Increasing numbers of women with complex congenital heart disease are reaching childbearing age. Pregnancy is a major issue in the management of adult congenital heart disease. Cardiac disease is one of the most common causes of maternal morbidity and mortality. Complications, such as growth retardation, preterm and premature birth and even fetal and neonatal mortality, are more frequent among children of women with congenital heart disease. The risk of complications is determined by the severity of the cardiac lesion, the presence of cyanosis, the maternal functional class and the use of anticoagulation. However, the pathophysiology of these complications is not completely understood and may be related to a diminished increase in cardiac output and/or endothelial dysfunction. The management of pregnant cardiac patients is based on limited clinical information. This article reviews pre-pregnancy counseling and management during pregnancy in patients with congenital heart disease.
越来越多患有复杂先天性心脏病的女性正步入育龄期。妊娠是成人先天性心脏病管理中的一个主要问题。心脏病是孕产妇发病和死亡的最常见原因之一。先天性心脏病女性的子女出现生长发育迟缓、早产和早育，甚至胎儿及新生儿死亡等并发症的情况更为常见。并发症的风险取决于心脏病变的严重程度、是否存在紫绀、孕产妇的心功能分级以及抗凝药物的使用。然而，这些并发症的病理生理学尚未完全明确，可能与心输出量增加减少和/或内皮功能障碍有关。妊娠心脏病患者的管理基于有限的临床信息。本文综述了先天性心脏病患者孕前咨询及孕期管理。
