Goldstein Sarah A, Ward Cary C
Duke University Medical Center, 2301 Erwin Rd, Box 2819, Durham, NC, 27710, USA.
Curr Cardiol Rep. 2017 Aug 24;19(10):96. doi: 10.1007/s11886-017-0910-6.
The number of pregnancies complicated by valvular heart disease is increasing. This review describes the hemodynamic effects of clinically important valvular abnormalities during pregnancy and reviews current guideline-driven management strategies.
Valvular heart disease in women of childbearing age is most commonly caused by congenital abnormalities and rheumatic heart disease. Regurgitant lesions are well tolerated, while stenotic lesions are associated with a higher risk of pregnancy-related complications. Management of symptomatic disease during pregnancy is primarily medical, with percutaneous interventions considered for refractory symptoms. Most guidelines addressing the management of valvular heart disease during pregnancy are based on case reports and observational studies. Additional investigation is required to further advance the care of this growing patient population.
合并瓣膜性心脏病的妊娠数量正在增加。本综述描述了孕期临床上重要的瓣膜异常的血流动力学影响，并回顾了当前指南驱动的管理策略。
育龄女性的瓣膜性心脏病最常见的病因是先天性异常和风湿性心脏病。反流性病变耐受性良好，而狭窄性病变与妊娠相关并发症的风险较高有关。孕期有症状疾病的管理主要是药物治疗，对于难治性症状可考虑经皮介入治疗。大多数关于孕期瓣膜性心脏病管理的指南基于病例报告和观察性研究。需要进一步研究以进一步改善对这一不断增长的患者群体的护理。
