Harris Rachel C, Fries Melissa H, Boyle Annelee, Adeniji-Adele Hassan, Cherian Zacharia, Klein Nancy, John Anitha S
Harvard Medical School, Massachusetts General Hospital, Boston, Mass, USA.
Congenit Heart Dis. 2014 Nov-Dec;9(6):E204-11. doi: 10.1111/chd.12163. Epub 2014 Jan 22.
With advancements in medical care, many women with complex congenital heart disease (CHD) are now living into adulthood and childbearing years. The strains of pregnancy and parturition can be dangerous in such patients, and careful interdisciplinary plans must be made to optimize maternal and fetal health through this process. Several large studies have been published regarding risk prediction and medical management of pregnancy in complex CHD, though few case studies detailing clinical care plans have been published. The objective of this report is to describe the process of developing a detailed pregnancy and delivery care plan for three women with complex CHD, including perspectives from the multidisciplinary specialists involved in the process. This article demonstrates that collaboration between specialists in the fields of cardiology, anesthesiology, high-risk obstetrics, maternal fetal medicine, and neonatology results in clinically successful individualized treatment plans for the management of pregnancy in complex CHD. Multidisciplinary collaboration is a crucial element in the management of pregnancy in complex CHD. We provide a template used in three cases which can serve as a model for the design of future care plans.
随着医疗护理的进步，许多患有复杂先天性心脏病（CHD）的女性如今已步入成年期和育龄期。对于这类患者，怀孕和分娩的压力可能很危险，因此必须制定细致的跨学科计划，以在此过程中优化母婴健康。关于复杂CHD患者怀孕的风险预测和医疗管理，已经发表了几项大型研究，但详细阐述临床护理计划的案例研究却很少。本报告的目的是描述为三名患有复杂CHD的女性制定详细的怀孕和分娩护理计划的过程，包括参与该过程的多学科专家的观点。本文表明，心脏病学、麻醉学、高危产科、母胎医学和新生儿学领域的专家之间的合作，可为复杂CHD患者的怀孕管理制定出临床上成功的个性化治疗方案。多学科合作是复杂CHD患者怀孕管理的关键要素。我们提供了在三个案例中使用的模板，可作为未来护理计划设计的模型。
