Wander Gurleen, Johnson Mark R, Patel Roshni R
Department of metabolism, digestion and reproduction, Imperial College London, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, SW10 9NH, London, United Kingdom.
Int J Cardiol Congenit Heart Dis. 2023 Aug 2;13:100470. doi: 10.1016/j.ijcchd.2023.100470. eCollection 2023 Sep.
Developments in medical and surgical techniques have improved survival in women with congenital heart disease (CHD) with most now surviving well into adulthood. Reproductive health amongst these women is underexplored and needs more attention. Women with CHD are known to have more menstrual dysfunction than the general population and have higher maternal and fetal risks when they become pregnant. Adequate and timely preconception counselling, including contraception within a multidisciplinary team (MDT) are essential to optimise pre pregnancy cardiac status and improve pregnancy outcomes. Counselling regarding fertility, sexuality, contraception and menopause is necessary and should start early, around 12-13 years, and as they transition into adult services. Fertility seems to be reduced in women with complex CHD and consideration for assisted reproduction technique (ART) should be assessed by the MDT as risks associated with ART including ovarian hyperstimulation syndrome, bleeding, thrombosis and infection can have profound effects on women with complex cyanotic CHD.
医学和外科技术的发展提高了先天性心脏病（CHD）女性的生存率，现在大多数患者都能顺利活到成年。这些女性的生殖健康尚未得到充分研究，需要更多关注。已知患有CHD的女性比普通人群有更多的月经功能障碍，怀孕时母婴风险更高。充分且及时的孕前咨询，包括在多学科团队（MDT）中进行避孕，对于优化孕前心脏状况和改善妊娠结局至关重要。关于生育、性、避孕和更年期的咨询是必要的，应该尽早开始，大约在12 - 13岁，并且在她们过渡到成人服务时进行。复杂CHD女性的生育能力似乎会下降，多学科团队应评估辅助生殖技术（ART）的适用性，因为与ART相关的风险，包括卵巢过度刺激综合征、出血、血栓形成和感染，可能会对复杂青紫型CHD女性产生深远影响。
