Riesgo Carmen Armida Iñigo, Gómez Luis Guillermo Torres, Higareda Salvador Hernández, Vargas Juan Rafael Gómez
Unidad Médica de Alta Especialidad, Hospital de Gineco-Obstetricia y Hospital de Pediatría, Centro Médico Nacional de Occidente, IMSS, México.
Ginecol Obstet Mex. 2008 Aug;76(8):461-7.
The Ebstein's anomaly is a congenital malformation of the tricuspid valve and of the right ventricle that usually is associated with interauricular communication, foramen oval, and arrhythmias of Wolff-Parkinson-White syndrome type.
To analyze the association between Ebstein's anomaly and pregnancy.
A prospective study was made in five pregnant women's with Ebstein's anomaly without surgery. We analyzed the clinical history, physical examination, electrocardiogram, x-ray of thorax, Doppler color heart ultrasound, and fetal valoration by means of pelvic ecosonogram and cardiotocographic registry, and routinely prenatal paraclinic tests.
We observed severe expansion of the ventricle and 3rd degree index of atrialization in two patients. In two pregnancies there were interatrial communication (patients with cyanosis) and in three was detected severe tricuspid insufficiency. The average of gestacional age was of 36.4 +/- 1.8 weeks. Two of the five pregnancies has preterm birth. Only one childbirth was short weight to gestational age. The rest stayed within percentile 10. There were no obits or neonatal deaths, either congenital abnormality by Doppler heart ultrasound.
The pregnancy is well tolerated in patients with Ebstein's anomaly; nevertheless, participation of multidisciplinary team is recommended to establish the treatment.
埃布斯坦畸形是一种三尖瓣和右心室的先天性畸形,通常与房间隔交通、卵圆孔未闭以及 Wolff-Parkinson-White 综合征型心律失常有关。
分析埃布斯坦畸形与妊娠之间的关联。
对 5 例未接受手术治疗的埃布斯坦畸形孕妇进行了一项前瞻性研究。我们分析了临床病史、体格检查、心电图、胸部 X 光、彩色多普勒心脏超声,通过盆腔超声心动图和胎心监护记录进行胎儿评估,并进行常规产前辅助检查。
我们观察到 2 例患者心室严重扩张和 3 度心房化指数。2 例妊娠存在房间隔交通(有紫绀的患者),3 例检测到严重三尖瓣关闭不全。平均孕周为 36.4±1.8 周。5 例妊娠中有 2 例早产。只有 1 例分娩的新生儿体重低于孕周标准。其余新生儿体重处于第 10 百分位数以内。未出现死产或新生儿死亡,也未通过多普勒心脏超声检测到先天性异常。
埃布斯坦畸形患者对妊娠耐受性良好;然而,建议多学科团队参与制定治疗方案。