Powless Cecelia A, Harms Roger W, Watson William J
Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905,USA.
J Matern Fetal Neonatal Med. 2010 Aug;23(8):850-3. doi: 10.3109/14767050903265089.
To review clinical experience at our institution on postural tachycardia syndrome (POTS) complicating pregnancy.
In a retrospective review, we identified nine pregnancies in seven patients with POTS syndrome at our institution.
Patients who did not require treatment for POTS before conception were less likely to have an exacerbation of symptoms or need reintroduction of treatment. Exacerbations of POTS during pregnancy are variable. Of our patients with exacerbations of symptoms, increases in the existing pharmacologic treatments, such as increasing beta-blocker dosage, was effective in palliation of symptoms. There were seven vaginal deliveries. Two patients delivered without neuraxial anesthesia; the other five deliveries were done using epidural anesthesia without associated complications. POTS does not seem to contribute to pregnancy-related complications. Importantly, there were no adverse intrapartum events attributable to POTS.
Pregnant women with POTS may undergo safe regional anesthesia and vaginal delivery. This contradicts earlier reports in the literature recommending cesarean delivery.
回顾我院关于体位性心动过速综合征（POTS）合并妊娠的临床经验。
在一项回顾性研究中，我们确定了我院7例患有POTS综合征的患者的9次妊娠情况。
受孕前无需治疗POTS的患者症状加重或需要重新开始治疗的可能性较小。妊娠期POTS症状的加重情况各不相同。在我们症状加重的患者中，增加现有药物治疗，如增加β受体阻滞剂剂量，对缓解症状有效。有7例经阴道分娩。2例患者未使用椎管内麻醉分娩；其他5例分娩采用硬膜外麻醉，未出现相关并发症。POTS似乎不会导致与妊娠相关的并发症。重要的是，没有可归因于POTS的不良分娩期事件。
患有POTS的孕妇可接受安全的区域麻醉和经阴道分娩。这与文献中早期推荐剖宫产的报道相矛盾。
