中国妇幼健康研究2011，Vol.22Issue(6)：836-838,3.DOI:10.3969/j.issn.1673-5293.2011.06.046
心脏瓣膜置换术后妊娠30例临床分析
Pregnancy after cardiac valve replacement: A clinical analysis of 30 cases
周丽华1
作者信息
- 1. 厦门大学附属中山医院妇产科,福建,厦门,361004
- 折叠
摘要
Abstract
Objetive To investigate the anti-coagulative therapy in gestational period after cardiac valve replacement and the delivery treatments. Methods 30 cases of pregnancy after cardiac valve replacement were treated from July 2004 to July 2010, a retrospective analysis was carried out concerning the application of anti-coagulative agents in gestational period and delivery, patterns of delivery and pregnancy outcomes. Results Two cases, who underwent cardiac valve replacement more than 10 years ago, accepted a second emergent valve replacement in midtrimester due to the mechanical dysfunction and prostheses thrombosis. Prostheses thrombosis and heart failure occurred late during pregnancy in 1 case who quitted anti-coagulative agents. There were 2 cases with gestational diabetes mellitus and 1 with hypertensive disorder complicating pregnancy. Induced labor was executed in mid-term in 3 cases ( 10. 00% ). There was vaginal delivery in 2 cases ( 6. 67% ) and C-sect in 25 cases ( 83. 33% ) without postpartum hemorrhage. Concerning the perinatal results there were 2 cases ( 6. 67% ) of hydrocephalus and 2 cases ( 6. 67% ) of fetal death. The range of birth weight was 1. 95 ~ 4. 2kg, and the average weight was 2. 90 ±0.43kg. There was 3 cases with low birth weight ( 10. 00% ), 1 case with fatal macrosomia ( 3. 33% )and 3 cases with neonatal asphyxia ( 10. 00% ). No one suffered from hypoxic ischemia or intracranial haemorrhage. Conclusion Both the time of cardiac valve replacement and anti-coagulative therapy during pregnancy affect pregnancy outcomes, and the optimal time for pregnancy may be 2nd or 3rd year after surgery. Oral administration of Warfarin turns out to be simple and easy to be accepted with low rate of deformity, which can prevent the prostheses thrombosis in pregnant women effectively. C-sect delivery is the first option for delivery. Stopping using of anti-coagulative agents in time before surgery and restoring within 24 hours after surgery is a safe method for maternity and fetus.关键词
妊娠/分娩/心脏瓣膜置换术/抗凝药物Key words
pregnancy/delivery/cardiac valve replacement/anti-coagulative agents分类
医药卫生引用本文复制引用
周丽华..心脏瓣膜置换术后妊娠30例临床分析[J].中国妇幼健康研究,2011,22(6):836-838,3.
