主动脉瓣置换术后女性的妊娠结局及心脏随访结局
Pregnancy outcome and follow-up cardiac outcome in women with aortic valve replacement.
作者信息
Basude Snehalata, Trinder Johanna, Caputo Massimo, Curtis Stephanie L
机构信息
Department of Obstetrics, St Michaels Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
出版信息
Obstet Med. 2014 Mar;7(1):29-33. doi: 10.1177/1753495X13514382. Epub 2014 Jan 15.
OBJECTIVES
To compare the maternal, fetal and cardiac outcomes in women who have undergone aortic valve replacement.
METHOD
Retrospective observational study of all women with aortic valve replacement, who underwent a pregnancy (1998-2012). Maternal-, fetal- and valve-related cardiac outcomes were assessed.
RESULTS
Thirty-two pregnancies in 16 women with aortic valve replacement (nine bioprosthetic, six Ross and 17 mechanical) were evaluated. There were no adverse maternal events in the bioprosthetic and Ross groups but three in the mechanical group. Fetal loss rate was highest in the mechanical valve pregnancies (53%). One woman in the bioprosthetic group needed valve re-operation, and one woman in the mechanical valve group died. There was no difference in the change of Vmax over the follow-up between the valves (p = 0.25).
CONCLUSIONS
There was no difference in deterioration between aortic valve replacements during and after pregnancy. The highest risk of maternal and fetal complications occurred in the mechanical valve group.
目的
比较接受主动脉瓣置换术的女性的母体、胎儿及心脏结局。
方法
对1998年至2012年间所有接受主动脉瓣置换术且怀孕的女性进行回顾性观察研究。评估母体、胎儿及瓣膜相关的心脏结局。
结果
对16例接受主动脉瓣置换术的女性（9例生物瓣、6例Ross瓣和17例机械瓣）的32次妊娠进行了评估。生物瓣组和Ross瓣组未发生不良母体事件，机械瓣组发生了3例。机械瓣妊娠的胎儿丢失率最高（53%）。生物瓣组有1名女性需要再次进行瓣膜手术，机械瓣组有1名女性死亡。随访期间各瓣膜间Vmax的变化无差异（p = 0.25）。
结论
孕期及产后主动脉瓣置换术之间的恶化情况无差异。机械瓣组发生母体和胎儿并发症的风险最高。
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