Lampert M B, Lang R M
Department of Medicine, University of Chicago Hospitals, IL 60637, USA.
Am Heart J. 1995 Oct;130(4):860-70. doi: 10.1016/0002-8703(95)90089-6.
Congestive heart failure is an uncommon complication of pregnancy with potentially life-threatening consequences. Peripartum cardiomyopathy is a disease of unknown cause in which severe left ventricular dysfunction occurs during late pregnancy or the early puerperium. In the past, the diagnosis of this entity was made on clinical grounds; however, modern echocardiographic techniques have allowed more accurate diagnoses by excluding cases of diseases that mimic the clinical symptoms and signs of heart failure. Risk factors for peripartum cardiomyopathy include advanced maternal age, multiparity, African descent, twinning, and long-term tocolysis. An extensive search for the causes of peripartum cardiomyopathy has been unrevealing. Treatment includes digitalis, diuretic agents, and vasodilators. Anticoagulation is strongly recommended, especially if ventricular function is persistent. The prognosis of peripartum cardiomyopathy is related to the recovery of ventricular function. Caution is advised in recommending subsequent pregnancy, especially if left ventricular dysfunction is persistent.
充血性心力衰竭是一种罕见的妊娠并发症，可能会产生危及生命的后果。围产期心肌病是一种病因不明的疾病，在妊娠晚期或产褥早期会出现严重的左心室功能障碍。过去，该疾病的诊断基于临床依据；然而，现代超声心动图技术通过排除那些模仿心力衰竭临床症状和体征的疾病病例，使得诊断更加准确。围产期心肌病的危险因素包括高龄产妇、多胎妊娠、非洲裔、双胎妊娠以及长期使用宫缩抑制剂。对围产期心肌病病因的广泛研究尚未有结果。治疗方法包括使用洋地黄、利尿剂和血管扩张剂。强烈建议进行抗凝治疗，尤其是在心室功能持续存在的情况下。围产期心肌病的预后与心室功能的恢复有关。建议在考虑再次妊娠时谨慎行事，尤其是在左心室功能持续存在的情况下。
