Patel Chandni, Akhtar Hubba, Gupta Shubhi, Harky Amer
Department of Medicine, St George's University of London, London, UK.
Department of Medicine, University of Liverpool, Liverpool, UK.
J Card Surg. 2020 Jul;35(7):1589-1596. doi: 10.1111/jocs.14637. Epub 2020 Jun 2.
Cardiac disease is the leading cause of maternal mortality in the United Kingdom. Major causes of cardiac death in pregnant women include cardiomyopathies, myocardial infarction, ischemic heart disease, and aortic dissection. Uncorrected congenital heart disease and women who have had corrective or palliative surgery may have complicated pregnancies as well. Some women with significant cardiac disease are unable to meet the increased physiological demands of pregnancy. Of these, those who do not respond to medical treatment may require surgical correction such as coronary artery bypass grafting. The risk of cardiac operations for pregnant women is similar to that for nonpregnant women but the fetal mortality rate remains high. Contributing factors to high fetal mortality rates include timing, urgency of operation, and the fetal/fetoplacental response to cardiopulmonary bypass. The aim of this review is to summarize current evidence in utilizing the different management approaches of cardiac issues during pregnancy.
在英国，心脏病是孕产妇死亡的主要原因。孕妇心脏死亡的主要原因包括心肌病、心肌梗死、缺血性心脏病和主动脉夹层。未经矫正的先天性心脏病患者以及接受过矫正或姑息性手术的女性也可能会经历复杂的妊娠。一些患有严重心脏病的女性无法满足孕期增加的生理需求。其中，那些对药物治疗无反应的患者可能需要进行手术矫正，如冠状动脉搭桥术。孕妇进行心脏手术的风险与非孕妇相似，但胎儿死亡率仍然很高。导致高胎儿死亡率的因素包括手术时机、手术紧迫性以及胎儿/胎儿-胎盘对体外循环的反应。本综述的目的是总结目前关于孕期心脏问题不同管理方法的证据。
