Hands M E, Johnson M D, Saltzman D H, Rutherford J D
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
J Clin Anesth. 1990 Jul-Aug;2(4):258-68. doi: 10.1016/0952-8180(90)90106-d.
Myocardial infarction (MI) occurring during pregnancy is a rare but potentially lethal event for both mother and fetus, particularly when it occurs in the third trimester or peripartum period. The authors report two cases of MI occurring in the third trimester of pregnancy and review the literature. Management of the acute infarct and the medical, obstetric, and anesthetic considerations in such patients during labor and delivery are discussed. Successful use of percutaneous transluminal coronary angioplasty is described in a patient with evolving MI and ongoing pain. The preferred method of delivery in the pregnant MI patient is addressed, with emphasis on the need for individualization of care and coordination between the cardiac, obstetric, and anesthetic teams. Finally, the authors review the risks of subsequent pregnancy in this patient population.
妊娠期间发生的心肌梗死（MI）虽罕见，但对母亲和胎儿都可能是致命事件，尤其是发生在孕晚期或围产期时。作者报告了两例孕晚期发生心肌梗死的病例并对文献进行了综述。讨论了此类患者在分娩时急性梗死的处理以及医疗、产科和麻醉方面的注意事项。文中描述了一名心肌梗死病情进展且持续疼痛的患者成功接受经皮腔内冠状动脉成形术的情况。探讨了妊娠心肌梗死患者的首选分娩方式，强调了个体化护理以及心脏科、产科和麻醉团队之间协调配合的必要性。最后，作者回顾了该患者群体再次妊娠的风险。
