Ertekin Ebru, van Hagen Iris M, Salam Amar M, Ruys Titia P E, Johnson Mark R, Popelova Jana, Parsonage William A, Ashour Zeinab, Shotan Avraham, Oliver José M, Veldtman Gruschen R, Hall Roger, Roos-Hesselink Jolien W
Erasmus University Medical Center, Rotterdam, The Netherlands.
Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Int J Cardiol. 2016 Oct 1;220:131-6. doi: 10.1016/j.ijcard.2016.06.061. Epub 2016 Jun 23.
To describe the incidence, onset, predictors and outcome of ventricular tachyarrhythmia (VTA) in pregnant women with heart disease.
VTA during pregnancy will cause maternal morbidity and even mortality and will have impact on fetal outcome. Insufficient data exist on the incidence and outcome of VTA in pregnancy.
From January 2007 up to October 2013, 99 hospitals in 39 countries enrolled 2966 pregnancies in women with structural heart disease. Forty-two women (1.4%) developed clinically relevant VTA during pregnancy, which occurred mainly in the third trimester (48%). NYHA class >1 before pregnancy was an independent predictor for VTA. Heart failure during pregnancy was more common in women with VTA than in women without VTA (24% vs. 12%, p=0.03) and maternal mortality was respectively 2.4% and 0.3% (p=0.15). More women with VTA delivered by Cesarean section than women without VTA (68% vs. 47%, p=0.01). Neonatal death, preterm birth (<37weeks), low birthweight (<2500g) and Apgar score <7 occurred more often in women with VTA (4.8% vs. 0.3%, p=0.01; 36% vs. 16%, p=0.001; 33% vs. 15%, p=0.001 and 25% vs. 7.3%, p=0.001, respectively).
VTA occurred in 1.4% of pregnant women with cardiovascular disease, mainly in the third trimester, and was associated with heart failure during pregnancy. NYHA class before pregnancy was predictive. VTA during pregnancy had clear impact on fetal outcome.
描述患有心脏病的孕妇室性快速心律失常（VTA）的发生率、发作情况、预测因素及结局。
孕期VTA会导致母体发病甚至死亡，并会影响胎儿结局。关于孕期VTA的发生率和结局的数据不足。
从2007年1月至2013年10月，39个国家的99家医院纳入了2966例患有结构性心脏病的孕妇。42名女性（1.4%）在孕期发生了具有临床意义的VTA，主要发生在孕晚期（48%）。孕前纽约心脏协会（NYHA）心功能分级>1级是VTA的独立预测因素。发生VTA的女性孕期心力衰竭比未发生VTA的女性更常见（24%对12%，p = 0.03），母体死亡率分别为2.4%和0.3%（p = 0.15）。发生VTA的女性剖宫产分娩的比例高于未发生VTA的女性（68%对47%，p = 0.01）。发生VTA的女性新生儿死亡、早产（<37周）、低出生体重（<2500g）和阿氏评分<7的情况更常见（分别为4.8%对0.3%，p = 0.01；36%对16%，p = 0.001；33%对15%，p = 0.001；25%对7.3%，p = 0.001）。
1.4%的患有心血管疾病的孕妇发生了VTA，主要在孕晚期，且与孕期心力衰竭相关。孕前NYHA心功能分级具有预测性。孕期VTA对胎儿结局有明显影响。
