中国全科医学Issue(4)：431-436,6.DOI:10.3969/j.issn.1007-9572.2016.04.015
不同类型人工心脏瓣膜置换术对妊娠结局的影响研究
Influence of Different Categories of Artificial Cardio Valve Replacement on Pregnancy Outcome
殷玲 1魏炜 2张军 3李燕娜 3李晓蕾 3曾汝园 1王以新 2冯妍1
作者信息
- 1. 412001 湖南省衡阳市，南华大学医学院
- 2. 首都医科大学附属北京安贞医院妇产科
- 3. 首都医科大学附属北京安贞医院妇产科
- 折叠
摘要
Abstract
Objective To investigate the influence of different types of artificial cardio valve replacement(CVR)on pregnancy outcome. Methods From April 2004 to April 2014,we enrolled 42 pregnant patients who had underwent CVR in Beijing Anzhen Hospital affiliated to Capital Medical University. According to different artificial heart valve implanted,the patients were divided into mechanical valve group and biological valve group. By reviewing medical records,the clinical data of the two groups were collected,including age,time between CVR and gestation,time of uterine pregnancy,hospitalization time, times of pregnancy,types of heart disease,sit of valve replacements,grading of cardiac function,anticoagulation condition, the status in perinatal period and complications of infants and mothers. Follow - up was conducted 42 days after delivery and in May 2014,and the prognosis of the two groups was recorded. Results The 42 subjects had all together 45 times of pregnancy, among which the mechanical valve group had 37 times of pregnancy and the biological valve group had 8 times of pregnancy. The two groups were not significantly different in average age,average uterine pregnancy time,average hospitalization time,types of cardiac disease,site of valve replacements and cardiac function grading(P > 0. 05);the two groups were significantly different in the average time between CVR to gestation and the average times of pregnancy(P < 0. 05). The patients of the biological valve group did not received anticoagulant therapy;the patients of the mechanical valve group were orally administrated with anticoagulation treatment of warfarin after surgery,and one patient died and 2 patients had intrauterine death and received induced labour. The two groups were not significantly different in delivery time,delivery mode and anesthesia method( P >0. 05). The two groups were significantly different in the amount of bleeding 24 hours after delivery(P < 0. 01). There were 44 alive newborns,among which 36 were of mechanical valve group and 8 were of biological valve group. The two groups were not significantly different in gender and average Apgar score of newborns(P > 0. 05),but they were significantly different in the average body weight of newborns(P < 0. 05). Forty - two days after deliver,25 pregnant women who completed follow - up and 26 newborns delivered by them recovered well. In May 2014,14 pregnant women who completed follow - up in mechanical valve group were still orally administrated with warfarin anticoagulation,and one patient had ecchymosis sometimes;8 patients of biological valve group had no obvious valve dysfunction and no valve replacement. Twenty - two newborns had no abnormalities. Conclusion Patients who undergo mechanical valve replacement have higher risk of complications than patients who undergo biological valve replacement. Complications of mother and infant may be related with the dosage of warfarin,while individual differences exist.关键词
妊娠结局/分娩/心脏瓣膜成形术/抗凝治疗Key words
Pregnancy outcome/Parturition/Cardiac valve annuloplasty/Anticoagulant therapy分类
医药卫生引用本文复制引用
殷玲,魏炜,张军,李燕娜,李晓蕾,曾汝园,王以新,冯妍..不同类型人工心脏瓣膜置换术对妊娠结局的影响研究[J].中国全科医学,2016,(4):431-436,6.
