Keepanasseril Anish, Maurya Dilip Kumar, Suriya Yavana J, Selvaraj Raja
Department of Obstetrics & Gynecology, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, India.
Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
BMJ Case Rep. 2015 Mar 9;2015:bcr2014208618. doi: 10.1136/bcr-2014-208618.
Obstetric management of a woman with a permanent pacemaker in situ is well reported in the literature; but those who present without pacing are still debatable. The necessity for setting the optimal timing or rate of temporary artificial pacing, specifically for labour, has not been objectively assessed. Temporary pacing in most cases reported in the literature might be to withstand the variations in haemodynamic status during delivery and labour. We report a case of a patient with complete heart block without any pacing who had seven pregnancies without any significant changes in haemodynamic status during labour and delivery. Managing a pregnancy without pacing might be an appropriate alternative for women without any underlying cardiac disorder, as it will not lead to significant changes in the haemodynamic system.
文献中对患有永久性起搏器的女性的产科管理已有充分报道；但对于未安装起搏器的女性，相关情况仍存在争议。专门针对分娩时设置临时人工起搏的最佳时机或频率的必要性，尚未得到客观评估。文献中报道的大多数病例进行临时起搏，可能是为了应对分娩和产程中血流动力学状态的变化。我们报告一例完全性心脏传导阻滞且未安装任何起搏器的患者，该患者经历了七次妊娠，分娩和产程中血流动力学状态均无显著变化。对于没有任何潜在心脏疾病的女性，不进行起搏管理妊娠可能是一种合适的选择，因为这不会导致血流动力学系统发生显著变化。
