房间隔转换术后大动脉转位女性妊娠和分娩的管理：16 年单中心经验。

Management of pregnancy and delivery in women with transposition of the great arteries after atrial switch operation: A 16-year single-center experience.

机构信息

Department of Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women's Medical University, Tokyo, Japan.

Department of Obstetrics, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

J Obstet Gynaecol Res. 2022 Feb;48(2):351-359. doi: 10.1111/jog.15111. Epub 2021 Dec 12.

DOI:10.1111/jog.15111

PMID:34897895

Abstract

AIM

This study aimed to summarize cases of successful pregnancy and delivery in patients with transposition of the great arteries (TGA) after atrial switch operation (ASO), to provide management, clinical experience, and maternal and fetal outcomes.

METHODS

During a 16-year period (2004-2019), we experienced 30 pregnancies in 15 patients after ASO at our institution. We retrospectively reviewed the medical records of the patients.

RESULTS

In 30 pregnancies, there were 21 (70%) live births, five (17%) miscarriages, and four (13%) artificial abortions. There were no maternal or neonatal deaths. Cardiac complications occurred in nine (43%) patients: deterioration of right ventricular (RV) function in one, symptomatic heart failure (HF) in three, supraventricular tachyarrhythmia requiring electrical cardioversion in two, sick sinus syndrome that required pacemaker implantation in two, and hemoptysis in one. Obstetric complications occurred in five (24%). Neonatal complications were premature births (delivery at <37 weeks of gestation) in 15 (71%), and birthweight <2500 g in 18 (86%). The mode of delivery consisted of vaginal delivery (VD) in five (24%), and cesarean section (CS) in 16 (76%).

CONCLUSION

A high incidence of preterm CS and cardiac complications including deterioration of RV function was observed in patients who had undergone ASO for TGA.

摘要

目的

总结大动脉转位（TGA）患者经心房调转术（ASO）后成功妊娠及分娩的病例，为临床管理提供经验，总结母婴结局。

方法

本研究回顾性分析了 16 年间（2004 年至 2019 年）在我院行 ASO 术后的 15 例患者的 30 例妊娠，总结其临床资料。

结果

30 例妊娠中，21 例（70%）活产，5 例（17%）流产，4 例（13%）人工流产。无孕产妇及新生儿死亡。9 例（43%）患者出现心脏并发症：1 例右心室（RV）功能恶化，3 例出现症状性心力衰竭（HF），2 例需要电复律的室上性心动过速，2 例病态窦房结综合征需要植入起搏器，1 例出现咯血。5 例（24%）患者出现产科并发症。15 例（71%）新生儿早产（<37 周），18 例（86%）新生儿出生体重<2500g。分娩方式包括 5 例（24%）阴道分娩（VD）和 16 例（76%）剖宫产（CS）。