The University of Newcastle, Faculty of Health, School of Medicine and Public Health, Newcastle, New South Wales, Australia; PhD Candidate, The University of Newcastle, Australia.
The University of Newcastle, Faculty of Health, School of Medicine and Public Health, Newcastle, New South Wales, Australia.
Auton Neurosci. 2018 Dec;215:106-118. doi: 10.1016/j.autneu.2018.05.003. Epub 2018 May 9.
Postural Orthostatic Tachycardia Syndrome is most commonly seen in women of child bearing age, however little is known about its effects in pregnancy.
A systematic review was conducted in March 2015 and updated in February 2018. Medline, Embase, PsychInfo, CINHAL, and the Cochrane Library were searched from database inception. The ClinicalTrials.gov site and bibliographies were searched. MeSH and Emtree headings and keywords included; Postural Orthostatic Tachycardia Syndrome, Postural Tachycardia Syndrome, and were combined with pregnancy and pregnancy related subject headings and keywords. Searches were limited to English. Eligible articles contained key words within the title and or abstract. Articles were excluded if Postural Orthostatic Tachycardia Syndrome was not pre-existing.
Eleven articles were identified as eligible for inclusion. Studies were appraised using the PRISMA 2009 guidelines. The overall quality of evidence was poor using the NHMRC Evidence Grading Matrix, which was attributed to small sample sizes and mostly observational studies, emphasizing the need for future high quality research. Findings in this review must be used with caution due to the poor quality of the literature available.
Postural Orthostatic Tachycardia Syndrome should not be a contraindication to pregnancy. Symptom course is variable during pregnancy and the post-partum period. Continuing pre-conception medication may help symptoms, with no significant risks reported. Obstetric complications, not Postural Orthostatic Tachycardia Syndrome, should dictate mode of delivery. Postural Orthostatic Tachycardia Syndrome did not appear to affect the rate of adverse events. These results are important in determining appropriate management and care in this population.
体位性心动过速综合征最常见于育龄期妇女，但对其在妊娠中的影响知之甚少。
系统评价于 2015 年 3 月进行，并于 2018 年 2 月更新。检索 Medline、Embase、PsychInfo、CINHAL 和 Cochrane 图书馆自数据库成立以来的内容。还检索了 ClinicalTrials.gov 网站和参考文献。MeSH 和 Emtree 标题和关键词包括：体位性心动过速综合征、体位性心动过速综合征，并与妊娠和妊娠相关主题标题和关键词相结合。检索仅限于英文。符合条件的文章标题和摘要中包含关键词。如果不存在体位性心动过速综合征，则排除文章。
确定了 11 篇符合纳入标准的文章。使用 PRISMA 2009 指南评估研究。使用 NHMRC 证据分级矩阵，证据总体质量较差，这归因于样本量小且主要为观察性研究，强调需要未来进行高质量研究。由于现有文献质量较差，本综述中的研究结果必须谨慎使用。
体位性心动过速综合征不应成为妊娠的禁忌症。症状在妊娠和产后期间呈多变性。继续孕前药物治疗可能有助于缓解症状，且未报告有显著风险。应根据产科并发症而不是体位性心动过速综合征来决定分娩方式。体位性心动过速综合征似乎并未影响不良事件的发生率。这些结果对于确定该人群的适当管理和护理非常重要。
