Ottman E H, Gall S A
Department of Obstetrics and Gynecology, University of Louisville School of Medicine, Kentucky.
Obstet Gynecol. 1993 May;81(5 ( Pt 2)):804-5.
Myocardial infarction during pregnancy is rare, at an estimated one case per 10,000 women delivered. The overall mortality rate is 28% and is even higher in the second and third trimesters. We report a myocardial infarction secondary to a thrombus that developed on an artificial aortic valve in a 25-year-old woman at 26 weeks' gestation.
The patient, gravida 6, para 3-0-2-3, presented with an acute myocardial infarction despite antepartum anticoagulant therapy with heparin. During her hospitalization, she experienced a second ischemic event, preterm labor, and a small upper gastrointestinal hemorrhage. Nitroglycerin, sublingual nifedipine, and heparin were used to stabilize her cardiac problems, and her uterine contractions were inhibited with tocolytic agents. At 35 weeks' gestation, she underwent an uncomplicated vaginal delivery of a 2608-g viable male infant.
Pregnancy complicated by myocardial infarction due to a valve thrombosis in the third trimester can be managed with careful attention to controlling the cardiac symptoms and preventing premature delivery.
妊娠期心肌梗死较为罕见，估计每10000例分娩女性中约有1例。总体死亡率为28%，在妊娠中期和晚期甚至更高。我们报告1例25岁女性，孕26周时因人工主动脉瓣上形成血栓继发心肌梗死。
该患者，孕6产3-0-2-3，尽管产前使用肝素进行抗凝治疗，仍发生急性心肌梗死。住院期间，她经历了第二次缺血事件、早产和少量上消化道出血。使用硝酸甘油、舌下含服硝苯地平和肝素稳定其心脏问题，并用宫缩抑制剂抑制子宫收缩。孕35周时，她顺利经阴道分娩出一名体重2608g的存活男婴。
妊娠晚期因瓣膜血栓并发心肌梗死，可通过密切关注控制心脏症状和预防早产来处理。
