Avila W S, Grinberg M, Snitcowsky R, Faccioli R, Da Luz P L, Bellotti G, Pileggi F
Heart Institute of the University of São Paulo, Brazil.
Eur Heart J. 1995 Apr;16(4):460-4. doi: 10.1093/oxfordjournals.eurheartj.a060936.
Interruption of pregnancy is usually recommended for pregnant women with Eisenmenger's syndrome. We studied 13 pregnancies in 12 women with this syndrome, who decided to carry on with their pregnancy despite recommendation for therapeutic abortion. The mean age was 27 years. Five patients had ventricular septal defect; two, persistent ductus arteriosus; one, a combination of both; two, atrial septal defect; one, atrioventricular septal defect and one patient a combination of ventricular and atrial septal defects. Mean systolic and diastolic arterial pulmonary pressures were 112.7 and 61.7, mmHg, respectively. There were three spontaneous abortions, one premature labour at 23 weeks of gestation and two maternal deaths during the 23 and 27 weeks of gestation. Seven patients who reached the end of the second trimester were hospitalized until delivery and received heparin (20,000 to 40,000 units per day) and oxygen therapy. Caesarean section was performed in all patients as a result of worsening maternal or fetal clinical condition during the third trimester of gestation. all the mothers were discharged from hospital but one of them died on the 30th day post-partum. Five of the eight infants were premature, three were small babies for gestational age and all were discharged from hospital with the exception of one who died 48 h after birth. In conclusion, although pregnancy should be discouraged in women with Eisenmenger's syndrome, it can be successful. In this study, prolonged bed rest, the use of heparin and oxygen therapy presumably positively influenced maternal and infant outcomes.
对于患有艾森曼格综合征的孕妇，通常建议终止妊娠。我们研究了12名患有该综合征的女性的13次妊娠情况，这些女性尽管被建议治疗性流产，但仍决定继续妊娠。平均年龄为27岁。5例患者有室间隔缺损；2例有动脉导管未闭；1例两者兼有；2例有房间隔缺损；1例有房室间隔缺损，1例患者有室间隔和房间隔缺损合并症。平均收缩期和舒张期动脉肺动脉压分别为112.7和61.7 mmHg。有3例自然流产，1例在妊娠23周时早产，2例母亲在妊娠23周和27周时死亡。7例妊娠至孕中期结束的患者住院直至分娩，并接受肝素（每天20,000至40,000单位）和氧疗。由于妊娠晚期母亲或胎儿临床状况恶化，所有患者均接受了剖宫产。所有母亲均出院，但其中1例在产后第30天死亡。8名婴儿中有5名早产，3名是小于胎龄儿，除1例出生后48小时死亡外，其余均出院。总之，尽管艾森曼格综合征女性应避免妊娠，但妊娠仍有可能成功。在本研究中，长时间卧床休息、使用肝素和氧疗可能对母婴结局产生了积极影响。
