Sananes S, Iung B, Vahanian A, Acar J, Salat-Baroux J, Uzan S
Clinique universitaire Guy-le-Lorier, Hôpital Tenon, Paris, France.
Fetal Diagn Ther. 1994 Jul-Aug;9(4):218-25. doi: 10.1159/000263936.
Since 1984 percutaneous mitral balloon commissurotomy (PMC) has replaced closed mitral commissurotomy in most of its indications. However the application of this technique to pregnant women had raised considerable concern essentially because of the risk of fetal distress and irradiation. Of 1,017 PMC performed between March 1986 and December 1992, 11 were carried out during pregnancy. At the time of the procedure gestational time ranged from 24 to 34 weeks of amenorrhea. PMC resulted in immediate hemodynamic improvement and there were no major maternal complications. Maternal abdominal radiation was always less than 0.2 mSv. Fetal heart rate was monitored during the procedure and showed only minor abnormalities. The outcomes of these 11 pregnancies were: 4 vaginal deliveries after 37 weeks, 5 cesarean sections after 37 weeks and 1 at 29 weeks. All newborn children were normotrophic and without malformation.
自1984年以来，经皮二尖瓣球囊交界切开术（PMC）在大多数适应证方面已取代了闭式二尖瓣交界切开术。然而，将该技术应用于孕妇引起了相当大的关注，主要是因为存在胎儿窘迫和辐射风险。在1986年3月至1992年12月期间进行的1017例PMC手术中，有11例是在孕期进行的。手术时，停经时间为24至34周。PMC导致即刻血流动力学改善，且无重大母体并发症。母体腹部辐射量始终小于0.2毫希沃特。术中监测胎儿心率，仅显示轻微异常。这11例妊娠的结局为：4例在37周后经阴道分娩，5例在37周后行剖宫产，1例在29周时分娩。所有新生儿营养正常，无畸形。
