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围生期心肌病产前和产后发病的临床结局和母体相关情况。

Clinical outcomes and maternal associated conditions between antepartum and postpartum-onset of peripartum cardiomyopathy.

机构信息

Department of Emergency, Kee-Lung Branch, Chang Gung Memorial Hospital, Kee-lung, Taiwan.

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2022 Nov;61(6):999-1003. doi: 10.1016/j.tjog.2022.03.046.

Abstract

OBJECTIVE

Peripartum cardiomyopathy (PPCM) developed from late pregnancy to five months after delivery. Women with PPCM have the risk of mortality or non-recovered cardiac function. We aimed to investigate women with PPCM in Taiwan.

MATERIALS AND METHODS

The retrospective study recruited patients with PPCM from January 2002 to October 2018 in a tertiary center. We evaluated the presentations, onset, associated conditions, maternal and fetal outcomes, follow-up cardiac function, and subsequent pregnancies. The clinical data were compared between antepartum and postpartum-onset of PPCM.

RESULTS

Thirty women were identified and seventeen (56.6%) patients were antepartum-onset. The delivery time, ranged from 26 to 40 weeks, was mostly at 35 weeks. Twenty-one patients had cardiac function follow-up and seven (33.3%) were non-recovered in six months. The associated conditions of PPCM included age >30, primiparity, preeclampsia or hypertension, obesity, twin pregnancy, and tocolysis. The maternal characteristics and associated conditions were not significant different, but early preterm (32.8 ± 3.6 vs. 35.5 ± 2.4 weeks, p = 0.042) and lower Apgar scores in one (7 vs. 9, p = 0.002) and 5 min (9 vs. 10, p = 0.005) were observed in the antepartum-onset group.

CONCLUSION

In conclusion, PPCM commonly occurred around 35 weeks of gestation, ranged from 26 to 40 weeks. Additionally, there were risks of early preterm and low Apgar scores in women with antepartum-onset of PPCM.

摘要

目的

围产期心肌病(PPCM)发生于妊娠晚期至产后 5 个月。患有 PPCM 的女性有死亡或心功能未恢复的风险。我们旨在研究台湾的 PPCM 患者。

材料与方法

本回顾性研究于一家三级中心招募了 2002 年 1 月至 2018 年 10 月期间患有 PPCM 的患者。我们评估了 PPCM 的临床表现、发病时间、相关疾病、母婴结局、随访心脏功能和后续妊娠情况。比较了产前和产后 PPCM 的发病情况。

结果

共确诊了 30 名患者,其中 17 名(56.6%)为产前发病。分娩时间范围为 26 周至 40 周,多在 35 周。21 名患者进行了心脏功能随访,其中 7 名(33.3%)在 6 个月时未恢复。PPCM 的相关疾病包括年龄>30 岁、初产妇、子痫前期或高血压、肥胖、双胎妊娠和保胎治疗。但两组的母体特征和相关疾病无显著差异,只是产前发病组的早产率较高(32.8±3.6 周比 35.5±2.4 周,p=0.042),新生儿 1 分钟和 5 分钟 Apgar 评分较低(7 分比 9 分,p=0.002;9 分比 10 分,p=0.005)。

结论

总之,PPCM 通常发生在妊娠 35 周左右,时间范围为 26 周至 40 周。此外,产前发病的 PPCM 患者有早产和新生儿低 Apgar 评分的风险。

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