Scott J R, Wagoner L E, Olsen S L, Taylor D O, Renlund D G
Department of Obstetrics and Gynecology, University of Utah Medical Center, Salt Lake City.
Obstet Gynecol. 1993 Sep;82(3):324-7.
To determine the outcome of pregnancies in cardiac allograft recipients.
Thirty women who became pregnant after heart transplantation were identified from cases managed personally, questionnaires sent to all cardiac transplant centers, and review of the literature. Mothers were evaluated for evidence of rejection and for obstetric complications. The infants were observed for congenital abnormalities and perinatal morbidity or mortality.
Frequent pregnancy complications included chronic hypertension (48%), preeclampsia (24%), and preterm labor (28%). The rate of cesarean delivery was 32%. Six episodes of rejection required treatment, and three late maternal deaths occurred. Among the 27 live births, 17 infants were born after 36 weeks' gestation and ten were preterm, five were small for gestational age, and four had neonatal complications. There were no congenital anomalies.
Pregnancies in heart transplant recipients present management problems similar to those seen in patients with other allografts and should be considered high risk.
确定心脏移植受者妊娠的结局。
通过个人管理的病例、向所有心脏移植中心发送问卷以及文献回顾，确定了30名心脏移植后怀孕的女性。对母亲进行排斥反应证据和产科并发症评估。观察婴儿是否有先天性异常以及围产期发病率或死亡率。
常见的妊娠并发症包括慢性高血压（48%）、先兆子痫（24%）和早产（28%）。剖宫产率为32%。发生了6次需要治疗的排斥反应，3名产妇晚期死亡。在27例活产中，17名婴儿在妊娠36周后出生，10名早产，5名小于胎龄，4名有新生儿并发症。无先天性异常。
心脏移植受者的妊娠存在与其他同种异体移植患者类似的管理问题，应视为高危妊娠。
