Luo Li, Sun Qiulei, Chen Liping, Ying Demei, Wu Xiaohua, Chen Zhengqiong
Department of Obstetrics and Gynecology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
J Obstet Gynaecol Res. 2017 Oct;43(10):1634-1638. doi: 10.1111/jog.13414. Epub 2017 Jul 14.
Infective endocarditis (IE) during pregnancy is a rare but serious condition. Cardiopulmonary bypass during pregnancy has a high rate of fetal morbidity and mortality. We here report the case of a 22-year-old pregnant woman with confirmed IE. Multiple large cardiac valve vegetations, severe aortic valve regurgitation, and hemodynamic compromise were observed. With full implementation of fetal monitoring and protection strategies, open heart surgery was performed at 31.4 weeks' gestation to aid survival, followed by an elective cesarean delivery at 34.4 weeks. As of the 3-month follow-up, both the mother and infant were in good health. This shows that a fetus can survive maternal thoracotomy under cardiopulmonary bypass with proper perioperative management, which means that this technique does not need to be excluded from consideration in the treatment of IE complicating pregnancy.
妊娠期感染性心内膜炎（IE）是一种罕见但严重的疾病。妊娠期体外循环有很高的胎儿发病率和死亡率。我们在此报告一例确诊为IE的22岁孕妇病例。观察到多个大的心脏瓣膜赘生物、严重主动脉瓣反流和血流动力学损害。在全面实施胎儿监测和保护策略后，于妊娠31.4周进行心脏直视手术以挽救生命，随后在34.4周进行择期剖宫产。截至3个月随访时，母婴均健康。这表明，通过适当的围手术期管理，胎儿能够在体外循环下母亲开胸手术中存活，这意味着在治疗妊娠合并IE时，这种技术无需排除在考虑范围之外。
