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目的:探讨先天性心脏病(先心病)孕产妇的管理。方法:分析3例未矫正的复杂先心病孕产妇的临床资料并复习文献。结果:患者年龄分别为24岁、26岁和28岁。孕龄6+w、36+w和34+w。其中单心房2例,合并有中/重度肺动脉高压,单心室并单心房1例,均无心脏畸形矫正术史。手术方式:人工流产1例,剖宫产2例。无孕产妇及胎儿死亡。2例过渡型房室间隔缺损伴单心房患者无并发症发生;1例单心室并单心房等多发心血管畸形患者孕晚期出现妊高症和心功能不全,产后出现室上性心律失常、腔静脉-心房部位附壁血栓、急性心肌梗死。结论:复杂先心病患者有较高的围产期心血管风险,能否妊娠应婚前咨询,一旦妊娠应及早终止妊娠,围产期需多学科参与的监护和治疗,提倡依据严密监测结果指导下的临床处理,减少并发症发生率,保证母婴安全。
Objective: To explore the management of pregnant women with congenital heart disease (CHD). Methods: Three cases of uncorrected complex congenital heart disease in pregnant women, clinical data and review the literature. Results: The patients were 24 years old, 26 years old and 28 years old respectively. Pregnancy 6 + w, 36 + w and 34 + w. Among them, there were 2 cases of single atrium, with moderate / severe pulmonary hypertension, single ventricle and single atrium in 1 case, no history of cardiac malformation. Surgical methods: 1 case of induced abortion, cesarean section in 2 cases. No maternal and fetal deaths. 2 cases of transitional atrioventricular septal defect with unilateral atrial complication without complications; 1 case of single ventricular and single atrial and other cardiovascular malformations appear in pregnancy late pregnancy induced hypertension and cardiac insufficiency, postpartum supraventricular arrhythmia, cavity Intravenous - atrial thrombosis, acute myocardial infarction. Conclusions: Patients with complex congenital heart disease have a higher risk of perinatal cardiovascular disease. Whether or not pregnancy should be counseled should be decided before marriage. Pregnancy should be terminated as soon as possible. Perinatal care and treatment should be involved in multidisciplinary participation. Advocacy should be based on close monitoring results The clinical treatment to reduce the incidence of complications to ensure the safety of mother and child.