实用妇产科杂志2012，Vol.28Issue(4)：274-277,4.
妊娠合并重度肺动脉高压28例临床分析
Clinical Analysis of 28 Pregnant Women with Severe Pulmonary Hypertension
汪敏 1黄引平 1许张晔 1陈金霞 1汤彪 1姚锋祥 1张胜坤1
作者信息
- 1. 温州医学院附属第一医院,浙江温州325000
- 折叠
摘要
Abstract
Objective:To probe the pregnancy outcome of women with severe pulmonary hypertension. Methods:Clinical data of 28 pregnant women with severe pulmonary hypertension in our hospital from November 2000 to March 2011 were retrospectively analyzed. According to the gestational week of severe pulmonary
hypertension occurrence, patients were divided into four groups; < 28 weeks for group I, 28 -31 +6 weeks for group II, 32 -35 +6 weeks for group III, ≥36 weeks for group IV. Results:1 case was primary pulmonary . hypertenskm( PPH), 27 case was Secondary pulmonary arterial hypertension (SPH) , in which 16 cases were rheumatic heart disease and 11 cases were congenital heart disease. 4 cases NYHA class were I ~ II and 24 cases NYHA class were HI ~ IV 12 cases were term delivery, 10 cases were premature delivery and 6 cases were induced labor in the second trimester of pregnancy. 21 cases were cesarean section, and 1 cases was vaginal delivery.2 mothers were death,1 case was very low birth weight infant,5 cases were neonatal asphyxia and 1 infant was death. The pulmonary artery pressure of group III was higher than group I and group IV, and the difference was statistically significant (P< 0.05); Comparing the rate of iatrogenic fetal loss,group I was obviously higher than group III and group IV, the difference was statistically significant (P< 0.05); Comparing the rate of term delivery,group IV was obviously higher than group II and group III, the difference was statistically significant (P< 0.05);Comparing the rate of neonatal suffocation,there was no significant statistical difference (P > 0.05) . Conclusions: At 32 ~ 35 +6 weeks , the pulmonary artery pressure is peak in pregnancy with severe pulmonary hypertension. The outcome of perineonate is related with the gestational week when occurring severe pulmonary hypertension and NYHA class. The smaller ges-tational age and the higher NYHA class, the higher rate of iatrogenic fetal loss ,the poorer outcome of perineonate. The patients in the first or second trimester are suggested to terminate pragnancy as early as possible. For the late pregnant patients, cesarean section is more suitable.
关键词
心脏病/重度肺动脉高压/妊娠结局Key words
Heart disease/ Severe pulmonary hypertension/ Pregnancy outcome分类
医药卫生引用本文复制引用
汪敏,黄引平,许张晔,陈金霞,汤彪,姚锋祥,张胜坤..妊娠合并重度肺动脉高压28例临床分析[J].实用妇产科杂志,2012,28(4):274-277,4.
