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患有心脏病的女性的妊娠结局。

Pregnancy outcomes of women with cardiac disease.

机构信息

Department of Obstetrics and Gynaecology, University of the West Indies, Kingston, Jamaica.

出版信息

Int J Gynaecol Obstet. 2023 Dec;163(3):1005-1011. doi: 10.1002/ijgo.15068. Epub 2023 Sep 11.

Abstract

OBJECTIVE

To determine and predict the maternal and neonatal outcomes of pregnancies occurring in patients with cardiac disease.

METHOD

This retrospective review included 147 pregnancies identified from antenatal, delivery, and nursery records. Information concerning the nature and severity of the pre-existing cardiac disease, comorbidities, risk scores, obstetric or cardiac complications, and pregnancy outcomes were collected. The data were analyzed using SPSS Windows version 22.

RESULTS

In all, 111 (73.5%) of the cohort had acquired heart disease and 4 (2.7%) of patients belonged to WHO class IV, in which pregnancy is not recommended. Additionally, 12 (8.1%) were categorized as being at significant risk of having a cardiac complication. The proportion of patients that had maternal and perinatal mortality was 6 (4.0%) and 7 (4.8%), respectively. The WHO and CARPREG scoring systems were reliably able to predict cardiac events (P < 0.01). Mothers who received preconception counseling had significantly fewer occurrences of cardiac and obstetric events than those who did not.

CONCLUSION

Cardiac disease in pregnancy in women managed at our center was most often an acquired disease. The baseline risk assessment scores accurately predicted the likelihood of adverse cardiac outcomes.

摘要

目的

确定和预测患有心脏病的患者妊娠的母婴结局。

方法

本回顾性研究纳入了从产前、分娩和新生儿病房记录中确定的 147 例妊娠。收集了有关先前存在的心脏病、合并症、风险评分、产科或心脏并发症以及妊娠结局的性质和严重程度的信息。使用 SPSS Windows 版本 22 对数据进行分析。

结果

在所有患者中,111 例(73.5%)患有获得性心脏病,4 例(2.7%)患者属于世界卫生组织(WHO)四级,不建议妊娠。此外,有 12 例(8.1%)被归类为存在发生心脏并发症的高风险。母婴死亡率分别为 6 例(4.0%)和 7 例(4.8%)。WHO 和 CARPREG 评分系统能够可靠地预测心脏事件(P<0.01)。接受孕前咨询的母亲发生心脏和产科事件的比例明显低于未接受咨询的母亲。

结论

在我们中心管理的患有心脏病的妊娠患者中,心脏病大多是后天获得的。基线风险评估评分准确预测了不良心脏结局的可能性。

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