Dib Chadi, Araoz Philip A, Davies Norman P, Dearani Joseph A, Ammash Naser M
Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Tex Heart Inst J. 2012;39(2):249-54.
Reversible causes of miscarriage are many, but they affect only 1% of women who are trying to conceive. Herein, we describe the case of a 23-year-old woman who presented for evaluation of repeated miscarriages and was found to have hypoxemia and erythrocytosis. Further evaluation revealed hypoplastic right-heart syndrome with an intracardiac shunt. She underwent hybrid repair with pulmonary valve balloon valvuloplasty, followed by surgery to perform atrial septal defect closure and a Glenn anastomosis. The erythrocytosis and hypoxemia resolved, and she was able to conceive and deliver a healthy baby at term 2 years later. This is a unique case of a rare congenital heart defect that went unnoticed until adulthood, when attempts at pregnancy failed because of the associated hypoxemia. Timely and appropriate treatment led to a successful pregnancy after repeated miscarriages. This case exemplifies the need for a comprehensive medical evaluation of every woman with a history of multiple miscarriages to determine whether a reversible cause exists.
流产的可逆性病因众多，但仅影响1%正在尝试受孕的女性。在此，我们描述了一名23岁女性的病例，她因反复流产前来评估，被发现存在低氧血症和红细胞增多症。进一步评估发现为右心发育不全综合征并伴有心内分流。她接受了包括肺动脉瓣球囊瓣膜成形术的杂交修复，随后进行了房间隔缺损封堵术和格林吻合术。红细胞增多症和低氧血症得以缓解，2年后她成功受孕并足月分娩了一个健康的婴儿。这是一例罕见的先天性心脏缺陷的独特病例，直到成年才被发现，当时由于相关的低氧血症导致妊娠尝试失败。及时且恰当的治疗使得反复流产后成功妊娠。该病例例证了对于每一位有多次流产史的女性进行全面医学评估以确定是否存在可逆性病因的必要性。
