目的:探讨妊娠合并先天性心脏病的类型以及心脏矫正手术对母婴结局的影响。方法:回顾性分析53例于2010年3月~2014年2月就诊的妊娠合并先天性心脏病孕妇及胎儿的临床资料。结果:先心病排名前三位的是房间隔缺损16例(占29.6%),室间隔缺损15例(占28.3%)和动脉导管未闭14例(占26.4%)。调查发现,心功能Ⅲ~Ⅳ级患者(占41.7%)较心功能Ⅰ~Ⅱ级患者(占82.3%)有较高的剖宫产率(P<0.05)。心功能Ⅰ~Ⅱ级的妊娠合并先心病患者的母婴并发症显著少于心功能Ⅲ~Ⅳ级的患者(P<0.05):心功能Ⅲ~Ⅳ级的先心病产妇的心衰及死亡发生率显著增高(P<0.05),胎儿生长受限、早产、子代先心病及围产儿死亡率明显增高(P<0.05)。53例中,有19例分娩前进行了心脏矫正手术(占35.8%)。手术组的剖宫产率55.9%,未手术组剖宫产率为47.4%,两者剖宫产率比较无统计学差异(P>0.05)。在手术组中,先心病产妇在妊娠及分娩期无心衰和死亡出现,且未出现新生儿FGR或死亡。与未进行心脏手术比较,其母婴并发症的发生率明显降低(P<0.05)。结论:对于妊娠合并先心病的患者,其母婴结局与心脏的功能状况密切相关,因此一旦确诊,应尽早手术治疗,经过心脏矫正手术后心功能良好的产妇,可获得较理想的母婴结局。 Objective: To investigate the types of congenital heart disease complicated by pregnancy and the effect of cardiac surgery on maternal and infant outcomes. Methods: The clinical data of 53 pregnant women and fetuses with congenital heart disease during pregnancy from March 2010 to February 2014 were retrospectively analyzed. Results: The top three cases of congenital heart disease were atrial septal defect in 16 cases (29.6%), ventricular septal defect in 15 cases (28.3%) and patent ductus arteriosus in 14 cases (26.4%). The survey found that patients with heart function Ⅲ ~ Ⅳ grade (41.7%) had higher cesarean section rate (P <0.05) than those with heart function Ⅰ ~ Ⅱ grade (82.3%). Maternal and neonatal complications of pregnancy with congenital heart disease Ⅰ ~ Ⅱ in pregnancy were significantly less than those in patients with Ⅲ ~ Ⅳ cardiac function (P <0.05). Heart failure and death of women with congenital heart disease Ⅲ ~ Ⅳ (P <0.05), fetal growth restriction, premature birth, preeclampsia and perinatal mortality were significantly increased (P <0.05). Of the 53 cases, 19 had cardiomyopathy (35.8%) before delivery. The cesarean section rate was 55.9% in the operation group and 47.4% in the non-operation group. There was no significant difference between the two groups (P> 0.05). In the surgery group, women with congenital heart disease did not have heart failure and death during pregnancy and childbirth, and no neonatal FGR or death occurred. Compared with no cardiac surgery, the incidence of maternal and child complications was significantly lower (P <0.05). Conclusion: For patients with congenital heart disease in pregnancy, the maternal and infant outcomes are closely related to cardiac function. Therefore, once diagnosed, surgical treatment should be done as soon as possible. After cardiac correction, patients with good cardiac function can obtain better maternal and infant outcomes .