Mehri Fateme, Saberi Kianoush, Salehi Mehrdad, Vahdani Fahimeh Ghotbizadeh, Larti Farnoosh, Bakhshandeh Alireza, Sheikhhasani Shahrzad
Department of Gynecology and Obstetrics, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Vali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Tehran Heart Cent. 2023 Oct;18(4):294-297. doi: 10.18502/jthc.v18i4.14829.
Pregnancy after a heart transplant is a concern for many female recipients, and it remains a medical challenge that raises many questions. A 24-year-old woman, gravida 3, para 0, contacted us for obstetric care in the first trimester of gestation, about 3 years after an orthotopic cardiac transplant. She was a known case of dextrocardia with congenitally corrected transposition of the great arteries. The transplant had been performed for severe retractable heart failure, manifesting during her previous lost pregnancy. The course of the current gestation was uneventful. The patient's cardiovascular function was good throughout the pregnancy. She was admitted to the hospital for dyspnea at 35 weeks and 4 days of gestational age. A cardiovascular consult and echocardiography were performed. The results were within the normal range, and labor pains explained the patient's dyspnea. Because of labor pain, a repeat Cesarean section was performed at 35 weeks and 4 days of gestational age. A male baby weighing 2700 g, with an Apgar score of 7/9, was delivered. The patient was discharged after delivery with enoxaparin (40 mg), prednisolone (5 mg), levothyroxine, and mycophenolate mofetil (500 mg) without any complications. Follow-up was carried out at 1 month, and no abnormality was found. Here, we report a case of a successful pregnancy in a young woman after a heart transplant.
心脏移植后怀孕是许多女性受者关注的问题，它仍然是一个医学挑战，引发了许多问题。一名24岁女性，孕3产0，在原位心脏移植约3年后，于妊娠早期联系我们寻求产科护理。她是已知的右位心合并先天性矫正型大动脉转位病例。此前因严重的难治性心力衰竭接受了移植手术，该心力衰竭在她之前的流产妊娠期间出现。本次妊娠过程顺利。患者在整个孕期心血管功能良好。她在孕35周零4天时因呼吸困难入院。进行了心血管会诊和超声心动图检查。结果在正常范围内，宫缩痛解释了患者的呼吸困难。由于宫缩痛，在孕35周零4天时进行了再次剖宫产。分娩出一名体重2700g的男婴，阿氏评分7/9。患者产后出院时服用依诺肝素（40mg）、泼尼松龙（5mg）、左甲状腺素和霉酚酸酯（500mg），无任何并发症。1个月后进行了随访，未发现异常。在此，我们报告一例年轻女性心脏移植后成功妊娠的病例。
