Krexi Dimitra, Sheppard Mary N
Cardiac Risk in the Young, Department of Cardiovascular Pathology, Cardiovascular Sciences Research Centre, St George's University of London, London, UK.
Cardiac Risk in the Young, Department of Cardiovascular Pathology, Cardiovascular Sciences Research Centre, St George's University of London, London, UK.
Eur J Obstet Gynecol Reprod Biol. 2017 May;212:155-159. doi: 10.1016/j.ejogrb.2017.03.006. Epub 2017 Mar 7.
This study aims to determine the causes of sudden cardiac death during pregnancy and in the postpartum period and patients' characteristics. There are few studies in the literature.
Eighty cases of sudden unexpected death due to cardiac causes in relation to pregnancy and postpartum period in a database of 4678 patients were found and examined macroscopically and microscopically.
The mean age was 30±7 years with a range from 16 to 43 years. About 30% were 35 years old or older; 50% of deaths occurred during pregnancy and 50% during the postpartum period. About 59.18% were obese or overweight where body mass index data were available. The leading causes of death were sudden arrhythmic death syndrome (SADS) (53.75%) and cardiomyopathies (13.80%). Other causes include dissection of aorta or its branches (8.75%), congenital heart disease (2.50%) and valvular disease (3.75%).
This study highlights sudden cardiac death in pregnancy or in the postpartum period, which is mainly due to SADS with underlying channelopathies and cardiomyopathy. We wish to raise awareness of these frequently under-recognised entities in maternal deaths and the need of cardiological screening of the family as a result of the diagnosis.
本研究旨在确定妊娠及产后期间心脏性猝死的原因及患者特征。文献中此类研究较少。
在一个包含4678例患者的数据库中，发现80例与妊娠及产后期间相关的心脏原因导致的意外猝死病例，并进行大体和显微镜检查。
平均年龄为30±7岁，范围为16至43岁。约30%的患者年龄在35岁及以上；50%的死亡发生在妊娠期，50%发生在产后。在有体重指数数据的患者中，约59.18%为肥胖或超重。主要死亡原因是心律失常性猝死综合征（SADS）（53.75%）和心肌病（13.80%）。其他原因包括主动脉或其分支夹层（8.75%）、先天性心脏病（2.50%）和瓣膜病（3.75%）。
本研究强调了妊娠或产后期间的心脏性猝死，主要原因是伴有潜在离子通道病和心肌病的SADS。我们希望提高对这些在孕产妇死亡中经常未被认识到的情况的认识，以及因诊断结果而对家族进行心脏筛查的必要性。
