Jana N, Vasishta K, Khunnu B, Dhall G I, Grover A
Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Asia Oceania J Obstet Gynaecol. 1993 Mar;19(1):61-5. doi: 10.1111/j.1447-0756.1993.tb00348.x.
Mitral valve prolapse (MVP) is considered to be the most common valvular heart lesion in adult females of reproductive age. Our report reviews the obstetrical performance and outcome of 34 pregnancies in 15 women with MVP. In 12 (80%) patients cardiac lesion was suspected due to enigmatic dyspnoea and palpitation during antenatal period. Four mothers required propranolol for cardiac arrhythmias. However, all of them tolerated pregnancy and labour well. Four pregnancies (11.8%) ended in spontaneous abortion and 1 mother had intrauterine fetal death due to severe pregnancy-induced hypertension. There were 25 (73.5%) term and 3 (8.8%) preterm neonates without congenital abnormality. One preterm neonate had tracheo-oesophageal fistula and died 6 hours after corrective surgery. The mean birth weight of 2.8 kg was appropriate for mean gestation of 38.5 weeks when compared to the Institute's reference neonatal weight curve. Infective endocarditis prophylaxis was recommended in cases having mitral regurgitation and complicated delivery. Awareness of this common cardiac lesion, thorough cardiovascular examination during pregnancy, early detection and treatment of cardiac arrhythmias if any, are the essential steps to prevent rare but dreaded maternal complications.
二尖瓣脱垂(MVP)被认为是育龄成年女性中最常见的心脏瓣膜病变。我们的报告回顾了15例患有MVP的女性的34次妊娠的产科表现及结局。12例(80%)患者在孕期因难以解释的呼吸困难和心悸而被怀疑有心脏病变。4位母亲因心律失常需要使用普萘洛尔。然而,她们均顺利耐受了妊娠和分娩。4次妊娠(11.8%)以自然流产告终,1位母亲因重度妊娠高血压综合征发生宫内胎儿死亡。有25例(73.5%)足月新生儿和3例(8.8%)早产新生儿无先天性异常。1例早产新生儿患有气管食管瘘,在矫正手术后6小时死亡。与该机构的参考新生儿体重曲线相比,平均出生体重2.8kg与平均妊娠38.5周相符。对于有二尖瓣反流和复杂分娩的病例,建议进行感染性心内膜炎预防。认识到这种常见的心脏病变、孕期进行全面的心血管检查、如有心律失常则尽早发现并治疗,是预防罕见但可怕的母体并发症的关键步骤。