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[获得性心脏缺陷女性的妊娠、分娩及产褥期问题]

[Pregnancy, labor and puerperal problems of women with acquired heart defects].

作者信息

Pavlov Ts, Khekimian A, Klinkachev A, Irasek V

出版信息

Vutr Boles. 1986;25(1):41-8.

PMID:3716361
Abstract

A total of 592 women in child-birth, at an average age between 15 and 42, mean 26.8 +/- 8.4 years, have been studied. The women with mitral valve defects predominate--83.9% (mitral stenosis--39.8%, mitral insufficiency--18.5% and combined mitral stenosis and insufficiency--41.7%), followed by the women with combined) aorto-mitral defects--9.8% and those with isolated aortic defects--6.3% (out of them with aortic stenosis 35.1%), aortic insufficiency--43.2% and combined aortic defect 21.7%). Pulmonary hypertension proved to have 83 women (14%), all with mitral and mitral-aortic defects. Cardiac insufficiency was established in 130 patients (22%-53.8%, stage I, 38.5%, stage II A and 7.7%--stage II B). Cardiac complications during pregnancy were observed in 29.6% of the patients, during delivery--in 5.4 and in puerperium--in 7.4%. Three women have died--one during delivery and two--during the early puerperal period. The percentage of the women that have given birth by via naturalis is 81.6% and the women that needed assistance--18.4%. A total of 587 viable children have been born (7 twins), 9--non-viable and 3--stillborn. A proper evaluation, in advance, of the cardiac affection and adequate behaviour during pregnancy and labour are necessary for the successful outcome of the pregnancy and delivery in females with valvular heart defects.

摘要

共研究了592名分娩期女性,平均年龄在15至42岁之间,平均年龄为26.8±8.4岁。患有二尖瓣缺陷的女性居多——占83.9%(二尖瓣狭窄——39.8%,二尖瓣关闭不全——18.5%,二尖瓣狭窄合并关闭不全——41.7%),其次是合并主动脉 - 二尖瓣缺陷的女性——占9.8%,以及孤立性主动脉缺陷的女性——占6.3%(其中主动脉狭窄占35.1%),主动脉关闭不全——占43.2%,合并主动脉缺陷占21.7%)。事实证明,有83名女性(14%)患有肺动脉高压,她们均患有二尖瓣和二尖瓣 - 主动脉缺陷。130名患者(22% - 53.8%,I期占38.5%,II A期占7.7%——II B期)被诊断为心功能不全。29.6%的患者在孕期出现心脏并发症,5.4%在分娩期出现,7.4%在产褥期出现。有3名女性死亡——1名在分娩期,2名在产褥早期。顺产的女性比例为81.6%,需要助产的女性比例为18.4%。共分娩出587名存活婴儿(7对双胞胎),9名未存活,3名死产。对于患有心脏瓣膜缺陷的女性,要想妊娠和分娩成功,必须提前对心脏疾病进行恰当评估,并在孕期和分娩时采取适当措施。

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