Pombar X, Strassner H T, Fenner P C
Department of Obstetrics and Gynecology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
Obstet Gynecol. 1995 May;85(5 Pt 2):825-9. doi: 10.1016/0029-7844(94)00440-o.
Maternal and fetal mortality have been reported to be high in pregnant women with diabetes mellitus and ischemic heart disease. Review of the literature identified only two cases of pregnancy after coronary artery bypass surgery in diabetic patients. Because of limited case experience, there are no clear recommendations for counseling and managing such patients.
We managed a pregnancy complicated by class H diabetes mellitus in which the patient had an earlier need for four-vessel coronary artery bypass surgery. The application of contemporary techniques for diabetic and cardiac management led to successful maternal and perinatal outcomes at 36 weeks' gestation.
Preconception coronary artery bypass surgery, along with contemporary medical and obstetric management, may lead to improvement in the outcome of pregnancies complicated by class H diabetes.
据报道，患有糖尿病和缺血性心脏病的孕妇的母婴死亡率很高。文献回顾发现，糖尿病患者冠状动脉搭桥术后妊娠的病例仅有两例。由于病例经验有限，对于此类患者的咨询和管理尚无明确建议。
我们管理了一例合并H级糖尿病的妊娠患者，该患者此前需要进行四支血管冠状动脉搭桥手术。采用当代糖尿病和心脏疾病管理技术，使患者在妊娠36周时获得了成功的母婴结局。
孕前冠状动脉搭桥手术，结合当代医学和产科管理，可能会改善合并H级糖尿病的妊娠结局。
