妊娠与肺动脉高压。

Pregnancy and pulmonary hypertension.

机构信息

Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, 333 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA.

Yale Pulmonary Hypertension Center, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, 333 Cedar Street, PO Box 28057, LLCI 105D, New Haven, CT 06520-8057, USA.

出版信息

Clin Chest Med. 2011 Mar;32(1):165-174. doi: 10.1016/j.ccm.2010.10.006.

DOI:10.1016/j.ccm.2010.10.006

PMID:21277457

Abstract

When pulmonary hypertension (PH) occurs in pregnancy, physiologic stress can overwhelm an already strained right ventricle resulting in right ventricular failure and death. Mortality remains unacceptably high (25%-30%). Patients with PH should be counseled to avoid pregnancy. This article discusses the physiologic changes of pregnancy that make it difficult for patients with PH, the pitfalls of transthoracic echocardiography in diagnosing PH in pregnancy, and the historical data regarding mortality. The causes of development of PH during pregnancy are discussed, and the limited data on management of patients with PH who choose to carry their pregnancy to term are reviewed.

摘要

当肺动脉高压 (PH) 在妊娠期间发生时，生理压力可能会使已经紧张的右心室不堪重负，导致右心衰竭和死亡。死亡率仍然高得令人无法接受 (25%-30%)。应告知 PH 患者避免怀孕。本文讨论了妊娠期间的生理变化，这些变化使 PH 患者难以应对，经胸超声心动图在诊断妊娠期间 PH 时的陷阱，以及关于死亡率的历史数据。讨论了 PH 在妊娠期间发展的原因，并回顾了选择将妊娠持续到足月的 PH 患者的有限管理数据。