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患有心血管疾病的孕妇:病理生理学、风险分层及母婴结局

Navigating pregnancy with cardiovascular disease: pathophysiology, risk stratification, and maternal-fetal outcomes.

作者信息

Türkmen Osman, Akar Inan Serra

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkiye.

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Health Sciences, Ankara, Turkiye.

出版信息

Turk J Med Sci. 2024 Nov 10;55(1):24-42. doi: 10.55730/1300-0144.5940. eCollection 2025.

Abstract

Pregnancy induces significant cardiovascular changes, including increases in heart rate, blood volume, and cardiac output, which may exacerbate existing heart conditions or unmask previously undiagnosed heart diseases. This review outlines the types of cardiovascular diseases that affect pregnant women, organized according to the modified World Health Organization risk classification. It covers key areas, including how pregnancy impacts the heart, common maternal and fetal complications, and effective management strategies. The review emphasizes the importance of preconception counseling, risk assessment, and continuous monitoring to ensure the best maternal and fetal outcomes. It also highlights practical guidelines for healthcare providers and discusses the latest research findings to improve clinical care for pregnant women with heart disease.

摘要

怀孕会引发显著的心血管变化,包括心率加快、血容量增加和心输出量增加,这些变化可能会加重现有的心脏疾病或使先前未被诊断出的心脏病显现出来。本综述根据世界卫生组织修改后的风险分类,概述了影响孕妇的心血管疾病类型。它涵盖了关键领域,包括怀孕如何影响心脏、常见的母婴并发症以及有效的管理策略。该综述强调了孕前咨询、风险评估和持续监测对于确保最佳母婴结局的重要性。它还突出了针对医疗保健提供者的实用指南,并讨论了最新的研究结果,以改善对患有心脏病的孕妇的临床护理。

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本文引用的文献

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Contemporary Management of Cardiomyopathy and Heart Failure in Pregnancy.妊娠期心肌病和心力衰竭的当代管理
Cardiol Ther. 2024 Mar;13(1):17-37. doi: 10.1007/s40119-024-00351-y. Epub 2024 Feb 10.
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J Family Med Prim Care. 2023 Nov;12(11):2714-2720. doi: 10.4103/jfmpc.jfmpc_507_23. Epub 2023 Nov 21.
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Pregnancy Considerations in Tetralogy of Fallot.法洛四联症的妊娠注意事项
CJC Pediatr Congenit Heart Dis. 2023 Sep 22;2(6Part A):301-313. doi: 10.1016/j.cjcpc.2023.09.008. eCollection 2023 Dec.
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High prevalence of pre-eclampsia in women with coarctation of the aorta.主动脉缩窄女性中先兆子痫的高患病率。
Eur Heart J Open. 2023 Jul 27;3(4):oead072. doi: 10.1093/ehjopen/oead072. eCollection 2023 Jul.
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J Cardiovasc Dev Dis. 2023 May 10;10(5):206. doi: 10.3390/jcdd10050206.

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