妊娠中期主动脉瓣置换术：一例病例报告

Aortic valve replacement in the second trimester of pregnancy: a case report.

作者信息

Mooij P N, de Jong P A, Bavinck J H, Korsten H H, Bonnier J J, Berendes J N

机构信息

Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, The Netherlands.

出版信息

Eur J Obstet Gynecol Reprod Biol. 1988 Dec;29(4):347-52. doi: 10.1016/0028-2243(88)90076-7.

DOI:10.1016/0028-2243(88)90076-7

PMID:3229547

Abstract

A 36 year old woman with left heart failure and right-sided hemiparesis due to endocarditis of the aortic valve underwent urgent aortic valve replacement during the 24th week of gestation. High-flow high-pressure normothermic perfusion during cardiopulmonary bypass was performed. Peri-operative fetal heart rate and uterine contractions were monitored. Severe fetal heart rate decelerations and loss of variability as well as uterine contractions were observed during surgery. Uterine contractions were treated medically. Pregnancy was carried to term and a healthy baby was delivered vaginally. The effect of the nonpulsating cardiac pump during extracorporeal circulation on the fetus will be discussed. Recommendations for the peri-operative management of the fetal unit are made.

摘要

一名36岁女性因主动脉瓣心内膜炎导致左心衰竭和右侧偏瘫，在妊娠第24周时接受了紧急主动脉瓣置换术。体外循环期间进行了高流量高压常温灌注。术中监测了胎儿心率和子宫收缩情况。手术过程中观察到严重的胎儿心率减速、变异性丧失以及子宫收缩。对子宫收缩进行了药物治疗。妊娠至足月，经阴道分娩出一名健康婴儿。将讨论体外循环期间非搏动性心脏泵对胎儿的影响。并提出了胎儿单元围手术期管理的建议。