Yuh-Jer Shen A, Mansukhani P W
Department of Medicine, Kaiser Permanente Medical Center, Los Angeles, CA 90027, USA.
Int J Cardiol. 1997 Jul 25;60(2):151-6. doi: 10.1016/s0167-5273(97)00066-1.
We report a cardiac allograft recipient who conceived 5 months after transplantation and spontaneously delivered a full term healthy baby girl. Pregnancy in cardiac transplant recipients is gradually becoming a more frequent issue as more patients in this population consider child bearing. In order to advise patients on potential adverse outcomes due to pregnancy, we reviewed the literature on pregnancy after cardiac transplantation. Published reports show that pregnancy in this population carry a higher risk for complications, in particular there is a higher incidence of pregnancy-induced hypertension, preeclampsia, premature labor, premature and low birth weight infants. The risk for these complications, however, is not higher than for pregnancies of renal or liver transplant recipients, to which pregnancy is not invariably advised against. Despite a greater frequency of complications during pregnancy, successful delivery of a healthy infant is the rule, without any detectable long-lasting adverse effects on both mother and offspring. Thus, while cardiac transplant recipients who wish to become pregnant should be counseled on possible complications, it appears that a satisfactory outcome can generally be expected. Additionally, we discuss further issues pertinent to the care of such patients, including hemodynamic changes, immunosuppression, and rejection surveillance during their pregnancies.
我们报告了一名心脏移植受者，她在移植后5个月怀孕并足月自然分娩了一名健康女婴。随着该人群中越来越多的患者考虑生育，心脏移植受者怀孕正逐渐成为一个更为常见的问题。为了就怀孕可能导致的不良后果向患者提供建议，我们查阅了有关心脏移植后怀孕的文献。已发表的报告显示，该人群怀孕出现并发症的风险更高，尤其是妊娠高血压、先兆子痫、早产、早产及低体重儿的发生率更高。然而，这些并发症的风险并不高于肾移植或肝移植受者怀孕的风险，而对于后者，怀孕并非总是被建议避免。尽管怀孕期间并发症更为常见，但成功分娩健康婴儿是常见情况，对母亲和后代均未发现任何可察觉的长期不良影响。因此，虽然希望怀孕的心脏移植受者应被告知可能的并发症，但似乎总体上可以预期会有令人满意的结果。此外，我们还讨论了与此类患者护理相关的其他问题，包括她们怀孕期间的血流动力学变化、免疫抑制和排斥监测。
