Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston MA, United States.
Adult Congenital Heart Disease Program/Cardiovascular Disease and Pregnancy Program, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston MA, United States.
Trends Cardiovasc Med. 2019 Apr;29(3):155-161. doi: 10.1016/j.tcm.2018.07.009. Epub 2018 Jul 22.
Cardiovascular disease contributes to approximately one third of all maternal mortality and remains a significant source of peri‑ and postpartum morbidity. As more women at risk for and with cardiovascular disease are desiring pregnancy, it is imperative that general cardiologists and obstetricians participate collaboratively in preconception counseling and are more facile with management of these lesions during peri‑ and postpartum periods. This review aims to address this growing need and highlights the management strategies for some of the major high risk cardiac conditions encountered during pregnancy including anticoagulation, cardiomyopathies as well as severe mitral and aortic stenosis; aortopathy, pulmonary hypertension, and severe congenital heart lesions will not be addressed.
心血管疾病导致约三分之一的孕产妇死亡,仍是围产期和产后发病率的重要来源。随着越来越多患有心血管疾病风险或已患有心血管疾病的女性希望怀孕,普通心脏病专家和妇产科医生必须共同参与孕前咨询,并更熟练地管理这些病变在围产期和产后期间。这篇综述旨在满足这一日益增长的需求,并重点介绍了一些在怀孕期间遇到的主要高危心脏疾病的管理策略,包括抗凝治疗、心肌病以及严重的二尖瓣和主动脉瓣狭窄;主动脉疾病、肺动脉高压和严重的先天性心脏病变将不做讨论。