左心室辅助装置和心脏移植受者的妊娠管理：简要综述
Management of pregnancy in left ventricular assist device and heart transplant recipients: a concise review.
作者信息
Marek-Iannucci Stefanie, Uber Patricia, Rajapreyar Indranee
机构信息
Division of Cardiology, Jefferson Heart Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
出版信息
Curr Opin Cardiol. 2023 May 1;38(3):257-265. doi: 10.1097/HCO.0000000000001036. Epub 2023 Mar 2.
PURPOSE OF REVIEW
Women of reproductive age are increasingly undergoing heart transplantation (HT) or left ventricular assist device (LVAD) implantation for advanced heart failure. This review is intended to give an overview of the current state of the art management of pregnancy in patients with LVAD or HT recipients.
RECENT FINDINGS
Heart transplant recipients are at increased risk for graft rejection, renal dysfunction, preeclampsia and worsening of comorbidities (hypertension and diabetes). Patients with LVAD are at higher risk of thromboembolic events, infections, right ventricular failure and require close surveillance during pregnancy. Preconception counseling must be offered to all women of reproductive age group with HT or LVAD to avoid unplanned pregnancies.
SUMMARY
A multidisciplinary approach with close antepartum and postpartum surveillance is recommended.
综述目的
育龄女性因晚期心力衰竭而接受心脏移植（HT）或植入左心室辅助装置（LVAD）的情况日益增多。本综述旨在概述LVAD患者或HT受者妊娠的当前先进管理状况。
最新发现
心脏移植受者发生移植物排斥、肾功能不全、先兆子痫和合并症（高血压和糖尿病）恶化的风险增加。LVAD患者发生血栓栓塞事件、感染、右心室衰竭的风险更高，孕期需要密切监测。必须为所有有HT或LVAD的育龄女性提供孕前咨询，以避免意外怀孕。
总结
建议采用多学科方法并进行密切的产前和产后监测。
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