Liao Hua, Hu Qing, Deng Chunyan, Wang Xiaodong, Yu Haiyan
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610041 Chengdu, Sichuan, China.
Rev Cardiovasc Med. 2022 May 12;23(5):172. doi: 10.31083/j.rcm2305172. eCollection 2022 May.
Pulmonary hypertension (PH) is a life-threatening disease with significant maternal morbidity and mortality.
To assess pregnancy and neonatal outcomes and determine the risk factors for adverse maternal and neonatal outcomes in women with pulmonary hypertension (PH), a retrospective analysis was carried out examining 71 pregnancies in patients with PH who delivered at a tertiary care center in West China between January 2011 and May 2016.
One pregnancy resulted in spontaneous abortion and six resulted in terminated abortions. Cardiac complications were encountered in 16.9% including three maternal mortalities. At least one pregnancy complication occurred in 28.2% of all the pregnancies. Diagnosis after the third trimester, severe PH and/or right ventricular systolic dysfunction were predictive of adverse fetal/neonatal events. A history of prior cardiac events and right ventricular systolic dysfunction and/or baseline New York Heart Association (NYHA) class III or IV were the main predictive factors of adverse maternal cardiac events.
In our study, we found that PH poses high risks for maternal and fetal morbidity and mortality. A detailed pre-pregnancy baseline assessment is strongly recommended in women with PH to identify those with the highest risk and subsequently guide clinical management.
肺动脉高压（PH）是一种危及生命的疾病，会导致严重的孕产妇发病率和死亡率。
为评估肺动脉高压（PH）女性患者的妊娠及新生儿结局，并确定不良孕产妇和新生儿结局的危险因素，我们进行了一项回顾性分析，研究了2011年1月至2016年5月期间在华西一家三级护理中心分娩的71例PH患者的妊娠情况。
1例妊娠导致自然流产，6例导致人工流产。16.9%的患者出现心脏并发症，其中包括3例孕产妇死亡。所有妊娠中，28.2%至少发生了一种妊娠并发症。孕晚期诊断、重度PH和/或右心室收缩功能障碍可预测不良胎儿/新生儿事件。既往心脏事件史、右心室收缩功能障碍和/或基线纽约心脏协会（NYHA）III或IV级是不良孕产妇心脏事件的主要预测因素。
在我们的研究中，我们发现PH对孕产妇和胎儿的发病率和死亡率构成高风险。强烈建议对PH女性患者进行详细的孕前基线评估，以识别风险最高的患者，从而指导临床管理。
