肥厚型梗阻性心肌病合并妊娠的管理
Management of pregnancy complicated by hypertrophic obstructive cardiomyopathy.
作者信息
Turner G M, Oakley C M, Dixon H G
出版信息
Br Med J. 1968 Nov 2;4(5626):281-4. doi: 10.1136/bmj.4.5626.281.
Abstract
We report our experiences with nine women suffering from hypertrophic obstructive cardiomyopathy who between them had 13 pregnancies, 10 of which were directly managed by us. Though at first we felt that the theoretical hazards of vaginal delivery indicated elective caesarean section, experience has convinced us that in the absence of an obstetrical contraindication these patients may be delivered vaginally provided a betaadrenergic blocking drug is administered during pregnancy and especially during labour, ergometrine is given at the end of the second stage, adequate supplies of cross-matched blood are available, and prophylaxis against infective endocarditis is administered. We have found no evidence of any adverse effects of either propranolol or pronethalol on the foetus.
摘要
我们报告了9例肥厚性梗阻性心肌病女性患者的情况，她们共有13次妊娠，其中10次由我们直接处理。起初我们认为阴道分娩存在理论上的风险，建议选择剖宫产，但经验使我们相信，在没有产科禁忌证的情况下，这些患者可以经阴道分娩，前提是在孕期尤其是分娩期间给予β肾上腺素能阻滞剂，第二产程结束时给予麦角新碱，有足够的交叉配血，并且给予感染性心内膜炎预防性用药。我们没有发现普萘洛尔或丙萘洛尔对胎儿有任何不良影响的证据。
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本文引用的文献
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Beta-adrenergic blockade in hypertrophic obstructive cardiomyopathy.肥厚性梗阻性心肌病中的β-肾上腺素能阻滞剂治疗
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