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一名26岁孕妇的先天性大动脉转位未经矫正:病例描述及文献综述

Congenitally uncorrected transposition of the great arteries in a pregnant woman 26-year-old: Description and literature review.

作者信息

Lahmouz Youssef, Ahchouch Sara, El Mangoub Fatima, Zaimi Achraf, Mouine Najat, Asfalou lIiyasse, Kouach Jaouad, Benyass Aatif

机构信息

Clinical cardiology department, Cardiology Center, Mohammed V Military Instruction Hospital of Rabat, Mohammed V University, Morocco.

Department of gynecology and obstetrics, Mohammed V Military Instruction Hospital of Rabat, Mohammed V University, Morocco.

出版信息

Radiol Case Rep. 2023 Apr 7;18(6):2154-2157. doi: 10.1016/j.radcr.2023.02.050. eCollection 2023 Jun.

Abstract

Complex congenital heart disease and pregnancy are a challenge and delicate medical situation. We describe a first-time pregnancy of a woman living with an uncorrected d-transposition of the great arteries (TGA) with serious fetal complications required multidisciplinary assessment. Twenty-six years old primigravida referred to our cardiology center in 34 weeks of gestation with peripheral cyanosis. The patient was stable hemodynamically and the room air oxygen was at 82%. A continuous murmur systolic and diastolic at second left intercostals space was found. The transthoracic echocardiographic showed an uncorrected TGA with a large atrial defect and patent ductus arteriosus. Obstetrical ultrasonography showed severe intrauterine growth restriction. The patient was delivered by caesarean section under epidural anesthesia with good outcome. This is a case report with discussion of the maternal-fetal outcome of pregnant women with asymptomatic uncorrected TGA. Coordinated care by an informed obstetrician and cardiologist should be the aim.

摘要

复杂先天性心脏病与妊娠是一项挑战,也是棘手的医疗状况。我们描述了一名患有未经矫正的大动脉 d 转位(TGA)的女性首次怀孕的情况,该病例出现了严重的胎儿并发症,需要多学科评估。一名 26 岁的初产妇在妊娠 34 周时因外周性发绀转诊至我们的心脏病中心。患者血流动力学稳定,室内空气下血氧饱和度为 82%。在左第二肋间发现连续性收缩期和舒张期杂音。经胸超声心动图显示为未经矫正的 TGA,伴有大型房间隔缺损和动脉导管未闭。产科超声检查显示严重的宫内生长受限。患者在硬膜外麻醉下接受剖宫产,结局良好。这是一篇病例报告,讨论了无症状未经矫正 TGA 孕妇的母胎结局。目标应是由经验丰富的产科医生和心脏病专家进行协调护理。

相似文献

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Guidelines for the Management of a Pregnant Trauma Patient.妊娠创伤患者管理指南
J Obstet Gynaecol Can. 2015 Jun;37(6):553-74. doi: 10.1016/s1701-2163(15)30232-2.

本文引用的文献

2
Transposition of the great arteries.大动脉转位
Orphanet J Rare Dis. 2008 Oct 13;3:27. doi: 10.1186/1750-1172-3-27.
9
Expanded care in obstetrics for the 1980s: preconception and early postconception counseling.
Am J Obstet Gynecol. 1984 Aug 15;149(8):811-4. doi: 10.1016/0002-9378(84)90596-9.

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