Adam Karolina
HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS.
Methodist Debakey Cardiovasc J. 2017 Oct-Dec;13(4):209-215. doi: 10.14797/mdcj-13-4-209.
Patients with cardiovascular disease represent a significant cohort at risk for complications during pregnancy. The normal physiologic changes of pregnancy could further compromise the hemodynamics of various cardiovascular conditions, resulting in clinical deterioration and even death. The fetus of a gravida with cardiovascular disease also has an increased risk of morbidity, including an increased risk of inherited cardiac genetic disorders, fetal growth restriction, and premature delivery. These complications also increase the risk for antenatal and perinatal mortality. Ideally, the management of a patient with cardiac disease who is considering pregnancy should start with pre-conception counseling that outlines the maternal and fetal complications associated with her particular cardiac disorder. The pregnancy is best managed by a dedicated team of specialists in maternal-fetal medicine, cardiology, cardiovascular surgery, anesthesiology, and neonatology, preferably in a tertiary care center.
患有心血管疾病的患者是孕期出现并发症的高危人群。孕期正常的生理变化会进一步损害各种心血管疾病的血流动力学,导致临床病情恶化甚至死亡。患有心血管疾病的孕妇所怀胎儿的发病风险也会增加,包括遗传性心脏遗传疾病、胎儿生长受限和早产风险增加。这些并发症还会增加产前和围产期死亡风险。理想情况下,对于考虑怀孕的心脏病患者的管理应从孕前咨询开始,概述与其特定心脏疾病相关的母婴并发症。最好由母胎医学、心脏病学、心血管外科、麻醉学和新生儿学方面的专业专家团队进行孕期管理,最好是在三级医疗中心。