Ray J, Sermer M
Department of Obstetrics and Gynaecology, Toronto Hospital, Ontario.
Can J Cardiol. 1996 Aug;12(8):753-6.
The case of a 25-year-old pregnant woman with systemic lupus erythematosus and severe pulmonary hypertension is presented. The pregnancy was complicated by worsening right heart failure and pre-eclampsia, requiring a caesarian section at 29 weeks' gestation. On the fourth day postpartum, the patient's respiratory status worsened and she was transferred to the coronary care unit where she soon died from combined right heart failure and respiratory arrest. The presumed pathogenesis and etiology of lupus-related pulmonary hypertension are discussed, in addition to noninvasive tests and proposed management. Given that the mortality rate is very high during pregnancy and therapy is of limited value, women with lupus-associated pulmonary hypertension should avoid conceiving. Those who choose to become pregnant must be carefully managed by a multidisciplinary team.
本文介绍了一名25岁患有系统性红斑狼疮和严重肺动脉高压的孕妇病例。该妊娠合并右心衰竭加重和子痫前期，在妊娠29周时需要进行剖宫产。产后第四天，患者的呼吸状况恶化，被转至冠心病监护病房，随后很快死于右心衰竭和呼吸骤停合并症。除了无创检查和建议的治疗方法外，还讨论了狼疮相关肺动脉高压的推测发病机制和病因。鉴于妊娠期间死亡率非常高且治疗价值有限，患有狼疮相关肺动脉高压的女性应避免怀孕。那些选择怀孕的女性必须由多学科团队进行仔细管理。
