Huras Hubert, Zembala-Szczerba Małgorzata, Rytlewski Krzysztof, Krawczyk Paweł, Tomasz Basta, Jach Robert
Przegl Lek. 2015;72(5):268-70.
It is estimated that 0.2-4% of all pregnancies are complicated by cardiovascular diseases in industrialized countries and the number of the patients with cardiac problems in pregnancy is currently increasing. Cardiomyopathy is a heart disease, congenital or acquired, that may cause heart impairment and as a consequence it may lead to insufficient adaptation under conditions of increased load during gestation. Cardiomyopathy during pregnancy occurs relatively rarely, but potentially it may have severe consequences. Moreover up to 11% of maternal deaths during pregnancy may be caused by cardiomyopathies. We present a series of clinical cases of cardiomyopathy diagnosed before pregnancy. In our observation there are two pregnant women with the hypertrophic cardiomyopathy and one pregnant woman with the dilated cardiomyopathy. Our experience corresponds with previous reports. Pregnancy in the course of cardiomyopathy, leading to changes in blood volume, cardiac output and peripheral vascular resistance, with the limited capacity of the heart, is a therapeutic challenge. The key to the successful therapy is to quantify precisely the risks for both the mother and the fetus. The counseling should be provided by a specialist with appropriate experience, and should be performed in the cooperation with obstetricians, cardiologists and anesthetists.
据估计,在工业化国家,所有妊娠中有0.2%-4%会并发心血管疾病,目前妊娠合并心脏问题的患者数量正在增加。心肌病是一种先天性或后天性心脏病,可能导致心脏功能受损,因此在妊娠期间负荷增加的情况下可能导致适应不足。妊娠期间的心肌病相对少见,但可能会产生严重后果。此外,妊娠期间高达11%的孕产妇死亡可能由心肌病引起。我们介绍了一系列妊娠前诊断为心肌病的临床病例。在我们的观察中,有两名孕妇患有肥厚型心肌病,一名孕妇患有扩张型心肌病。我们的经验与之前的报告一致。在心肌病病程中妊娠,会导致血容量、心输出量和外周血管阻力发生变化,而心脏功能有限,这是一个治疗挑战。成功治疗的关键是精确量化对母亲和胎儿的风险。咨询应由有适当经验的专科医生提供,并应与产科医生、心脏病专家和麻醉师合作进行。