Jastrow N, Meyer P, Bouchardy J, Savoldelli G L, Irion O
Service d'obstétrique, Département de gynécologie et obstétrique, HUG, 1211 Genève.
Rev Med Suisse. 2011 Oct 26;7(314):2070, 2072-4, 2076-7.
In developed countries, cardiovascular diseases are becoming one of the first causes of maternal death. Myocardial infarction, dissection of the thoracic aorta and cardiomyopathies are the leading causes. However, preexisting maternal cardiac diseases, such as congenital heart diseases, are more commonly encountered and may be associated with significant maternal and perinatal morbidity. This article reviews hemodynamic changes occurring during pregnancy, proposes a risk stratification according to pre-existing cardiac diseases, and discusses the monitoring and overall management of these patients. Finally, two pregnancy-triggered cardiac diseases are discussed: coronary artery disease and peripartum cardiomyopathy.
在发达国家,心血管疾病正成为孕产妇死亡的首要原因之一。心肌梗死、胸主动脉夹层和心肌病是主要病因。然而,孕产妇先前存在的心脏疾病,如先天性心脏病,更为常见,且可能伴有严重的孕产妇和围产期发病率。本文回顾了孕期发生的血流动力学变化,根据先前存在的心脏疾病提出了风险分层,并讨论了这些患者的监测和整体管理。最后,探讨了两种由妊娠引发的心脏疾病:冠状动脉疾病和围产期心肌病。