Lu Chun-Wei, Wu Mei-Hwan, Wang Jou-Kou, Lin Min-Tai, Chen Chun-An, Chiu Shenn-Nan, Chiu Hsin-Hui
Adult Congenital Heart Center, Department of Pediatric Cardiology, National Taiwan University Children Hospital, Taipei, Taiwan.
Acta Cardiol Sin. 2015 Nov;31(6):500-6. doi: 10.6515/acs20150319b.
With advances that have been made over the recent decades in transcatheter and surgical interventions, most patients with congenital heart disease (CHD) can survive into adulthood. Overall, probably half of these surviving patients are female. When these female CHD patients reach childbearing age, however, pregnancy management will be a major issue. In order to meet the demands of fetal growth, the maternal cardiovascular system starts a series of adaptations beginning in early pregnancy. These adaptations include: decreased systemic and pulmonary vascular resistances, decreased blood pressure, expansion of the blood volume, increased heart rate and increased cardiac output. For women with CHD, this hemodynamic alteration may increase the risks of adverse cardiovascular events as well as the fetal and neonatal complications. Therefore, proper risk stratification and effective counseling for women with CHD who are planning their pregnancies is an important undertaking.
Congenital heart disease; Pregnancy.
随着近几十年来经导管和外科手术干预技术的进步,大多数先天性心脏病(CHD)患者能够存活至成年。总体而言,这些存活患者中可能约有一半为女性。然而,当这些患有先天性心脏病的女性患者达到育龄时,妊娠管理将成为一个主要问题。为了满足胎儿生长的需求,孕妇的心血管系统在妊娠早期就开始一系列适应性变化。这些适应性变化包括:全身和肺血管阻力降低、血压下降、血容量增加、心率加快和心输出量增加。对于患有先天性心脏病的女性来说,这种血流动力学改变可能会增加不良心血管事件以及胎儿和新生儿并发症的风险。因此,对计划怀孕的先天性心脏病女性进行适当的风险分层和有效的咨询是一项重要工作。
先天性心脏病;妊娠