De Feo Stefania, Iacovoni Attilio, Faggiano Pompilio
Divisione di Cardiologia, Casa di Cura Polispecialistica Dr. Pederzoli, Peschiera del Garda (VR), Spedali Civili e Universiti degli Studi, Brescia.
G Ital Cardiol (Rome). 2012 May;13(5 Suppl 1):42S-53S.
Heart diseases are the leading cause of maternal morbidity and mortality. The number of patients with congenital heart diseases reaching childbearing age, as well as the proportion of women with acquired conditions, such as ischemic heart disease, becoming pregnant is constantly increasing. All women with known heart disease should have pre-pregnancy counseling, to assess maternal and fetal risk. Women at moderate or high risk should be under the care of a specialist prenatal team with experience in managing women with heart disease during pregnancy. Conditions that are considered at particularly high risk (mortality >10%) include Marfan syndrome with dilated aortic root, severe left ventricular dysfunction, severe left heart obstructive lesions, and pulmonary hypertension. Peripartum cardiomyopathy is a rare and potentially fatal disease related to pregnancy and the postnatal period that presents with symptoms of congestion and/or hypoperfusion and may rapidly progress to acute and life-threatening heart failure. However, the majority of women with heart disease can tolerate pregnancy; therefore an adequate multidisciplinary approach with the gynecologist, anesthesiologist and cardiologist should be advocated in order to reduce maternal and fetal risks associated with pregnancy.
心脏病是孕产妇发病和死亡的主要原因。达到生育年龄的先天性心脏病患者数量，以及患有诸如缺血性心脏病等后天性疾病的女性怀孕的比例都在不断增加。所有已知患有心脏病的女性都应接受孕前咨询，以评估母婴风险。中度或高危女性应由在孕期管理心脏病女性方面有经验的专业产前团队进行护理。被认为特别高危（死亡率>10%）的情况包括伴有主动脉根部扩张的马凡综合征、严重左心室功能不全、严重左心梗阻性病变和肺动脉高压。围产期心肌病是一种与妊娠和产后相关的罕见且可能致命的疾病，表现为充血和/或灌注不足症状，可能迅速发展为急性且危及生命的心力衰竭。然而，大多数患有心脏病的女性能够耐受妊娠；因此，应提倡妇科医生、麻醉师和心脏病专家采取充分的多学科方法，以降低与妊娠相关的母婴风险。
