不同心脏病类型与心功能状态对妊娠合并心脏病患者母婴预后影响
|
摘要
目的:探讨不同心脏病类型与心功能状态对妊娠合并心脏病患者母婴预后的影响。方法:回顾性收集128例在本院住院分娩的妊娠合并心脏病患者,根据患者心脏病类型及心功能状态的不同分组,对比不同类型及状态患者母婴预后。结果:美国纽约心脏学会(NYHA)Ⅲ～Ⅳ级组的剖宫产率(94.3%)高于Ⅰ～Ⅱ级组(79.6%),分娩孕周及新生儿体重低于Ⅰ～Ⅱ级组,孕产妇心衰、早产、足月低体重儿、围生儿死亡、新生儿窒息发生率均高于Ⅰ～Ⅱ级组(均P<0.05)。心律失常组剖宫产率低于其他心脏病类型组分娩孕周、新生儿体重高于其他心脏病类型组,孕产妇心衰、早产、足月低体重儿、围生儿死亡、新生儿窒息发生率均低于其他心脏病类型组(均P<0.05)。其它各组无差异。结论:NYHAⅢ～Ⅳ级心脏病孕妇的心衰、早产、足月低体重儿、围生儿死亡、新生儿窒息发生率较高,母婴预后更差。心律失常者母婴预后相对较好,先天性心脏病、风湿性心脏病、高血压心脏病、心肌病者母婴预后情况接近。
Objective: To explore the influences of different heart disease types and cardiac function status of pregnant women with heart disease on the maternal and infant prognosis. Methods: The data of 128 pregnant women with heart disease were retrospectively analyzed, and all included women were divided into group A(women with NYHAIII-IV class) and group B(women with NYHA I-II class) according to the type of heart disease and cardiac function. The maternal and child prognosis were compared between the two groups. Results: The cesarean section rate of women in group A was 94.3%, which was significantly higher than that(79.6%) of women in group B. The gestational weeks when delivery of women, the weight of the newborns in group A were significant higher than those of women in group B(P<0.05), but the incidences of maternal heart failure, premature delivery, low birth weight infants of full-term delivery, perinatal death, and neonatal asphyxia of women in group A were significant higher than those of women in group B(P<0.05). There were no significant different in cesarean section rate among the women with congenital heart disease, the women with rheumatic heart disease, the women with hypertensive heart disease, and the women with cardiomyopathy(P>0.05). The gestational weeks when delivery and weight of the newborn of women with arrhythmia were significant higher than those of women with other types of heart disease, but the rates of maternal heart failure, premature delivery, full-term low birth weight, perinatal death, neonatal asphyxia were significant lower(P<0.05). Conclusion: The pregnant women with NYHA III～IV class have higher rates of heart failure, premature delivery, full-term low birth weight, perinatal death, neonatal asphyxia, and they has worse maternal and child prognosis. As for pregnant women with different type of heart disease, the maternal and infant prognosis of women with arrhythmia is relatively better, and the maternal and infant prognosis of women with congenital heart disease, rheumatic heart disease, hypertensive heart disease, and cardiomyopathy are almost the same.
Objective: To explore the influences of different heart disease types and cardiac function status of pregnant women with heart disease on the maternal and infant prognosis. Methods: The data of 128 pregnant women with heart disease were retrospectively analyzed, and all included women were divided into group A(women with NYHAIII-IV class) and group B(women with NYHA I-II class) according to the type of heart disease and cardiac function. The maternal and child prognosis were compared between the two groups. Results: The cesarean section rate of women in group A was 94.3%, which was significantly higher than that(79.6%) of women in group B. The gestational weeks when delivery of women, the weight of the newborns in group A were significant higher than those of women in group B(P<0.05), but the incidences of maternal heart failure, premature delivery, low birth weight infants of full-term delivery, perinatal death, and neonatal asphyxia of women in group A were significant higher than those of women in group B(P<0.05). There were no significant different in cesarean section rate among the women with congenital heart disease, the women with rheumatic heart disease, the women with hypertensive heart disease, and the women with cardiomyopathy(P>0.05). The gestational weeks when delivery and weight of the newborn of women with arrhythmia were significant higher than those of women with other types of heart disease, but the rates of maternal heart failure, premature delivery, full-term low birth weight, perinatal death, neonatal asphyxia were significant lower(P<0.05). Conclusion: The pregnant women with NYHA III～IV class have higher rates of heart failure, premature delivery, full-term low birth weight, perinatal death, neonatal asphyxia, and they has worse maternal and child prognosis. As for pregnant women with different type of heart disease, the maternal and infant prognosis of women with arrhythmia is relatively better, and the maternal and infant prognosis of women with congenital heart disease, rheumatic heart disease, hypertensive heart disease, and cardiomyopathy are almost the same.
引文
[1] 傅勤,林建华.妊娠合并心脏病患者心血管风险评估系统研究进展[J].中国实用妇科与产科杂志,2016,32(2):201-203.
[2] 靳晴,陈雪蓉,牛兆仪,等.妊娠合并心脏病患者不同心功能状态对心脏不良事件和妊娠结局的影响[J].实用临床医药杂志,2016,20(07):192-194.
[3] 李霞.妊娠合并心脏病不同心功能妊娠结局的临床分析[J].中国当代医药,2016,23(22):123-125.
[4] 张大伟,王焕英,李燕娜,等.妊娠合并心脏病患者妊娠结局影响因素分析[J].中华实用诊断与治疗杂志,2015,29(6):574-576.
[5] 林庚海,林月丽,王淑贞.妊娠并发心脏病患者自然分娩的心血管风险评估体系的构建[J].岭南心血管病杂志,2018,24(2):205-209.
[6] 郑玉霞,孙秀云.妊娠合并先天性心脏病相关肺动脉高压患者围产期结局及影响因素分析[J].中国计划生育学杂志,2018,26(6):478-482.
[7] 冯亚徽,李杨.浅析妊娠合并心脏病不同心功能妊娠结局的临床效果[J].中外女性健康研究,2018(12):46+75.
[8] 宋俏莉,梁杰聪.风湿性心脏病并肺高压妊娠患者的临床特征及妊娠结局[J].广州医科大学学报,2016,44(5):54-56.
[9] Goldstein SA,Ward CC.Congenital and Acquired Valvular Heart Disease in Pregnancy[J].Curr Cardiol Reps,2017,19(10):96.
[10] van Hagen IM,Baart S,Fong Soe Khioe R,et al.Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease[J].Heart,2018,104(9):745-752.
[2] 靳晴,陈雪蓉,牛兆仪,等.妊娠合并心脏病患者不同心功能状态对心脏不良事件和妊娠结局的影响[J].实用临床医药杂志,2016,20(07):192-194.
[3] 李霞.妊娠合并心脏病不同心功能妊娠结局的临床分析[J].中国当代医药,2016,23(22):123-125.
[4] 张大伟,王焕英,李燕娜,等.妊娠合并心脏病患者妊娠结局影响因素分析[J].中华实用诊断与治疗杂志,2015,29(6):574-576.
[5] 林庚海,林月丽,王淑贞.妊娠并发心脏病患者自然分娩的心血管风险评估体系的构建[J].岭南心血管病杂志,2018,24(2):205-209.
[6] 郑玉霞,孙秀云.妊娠合并先天性心脏病相关肺动脉高压患者围产期结局及影响因素分析[J].中国计划生育学杂志,2018,26(6):478-482.
[7] 冯亚徽,李杨.浅析妊娠合并心脏病不同心功能妊娠结局的临床效果[J].中外女性健康研究,2018(12):46+75.
[8] 宋俏莉,梁杰聪.风湿性心脏病并肺高压妊娠患者的临床特征及妊娠结局[J].广州医科大学学报,2016,44(5):54-56.
[9] Goldstein SA,Ward CC.Congenital and Acquired Valvular Heart Disease in Pregnancy[J].Curr Cardiol Reps,2017,19(10):96.
[10] van Hagen IM,Baart S,Fong Soe Khioe R,et al.Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease[J].Heart,2018,104(9):745-752.