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目的探讨心脏手术后的患者能否安全度过妊娠及分娩期的主要因素。方法对1984年1月至1997年12月住院分娩的心脏手术后患者临床资料进行回顾性分析。结果25例中先心病17例占68%,心脏瓣膜病8例占32%。所施手术有房、室间隔缺损修补术15例,二尖瓣置换术5例,二尖瓣狭窄分离术1例,二尖瓣扩张术、动脉导管结扎术各2例。患者术后均未发生过心衰,妊娠及分娩期心功能Ⅰ~Ⅱ级。分娩方式:剖宫产11例,产钳助产3例,胎头吸引器助产2例,正常产9例。娩出男婴18例,女婴7例,均存活,无显形畸形。结论心脏手术后能否妊娠与妊娠前心脏矫治术有关,术后心功能分级亦是能否耐受妊娠的另一因素。若术后心功能Ⅰ~Ⅱ级多能安全度过妊娠及分娩期,但属高危妊娠应加强孕产期监护
Objective To investigate whether patients after cardiac surgery can safely pass the main factors of pregnancy and childbirth. Methods The clinical data of patients after cardiac surgery hospitalized from January 1984 to December 1997 were analyzed retrospectively. Results 25 cases of congenital heart disease in 17 cases accounted for 68%, 8 cases of heart valve disease accounted for 32%. The operation of a room, ventricular septal defect repair in 15 cases, mitral valve replacement in 5 cases, mitral stenosis in 1 case, mitral valve dilatation, ductus arteriosus in 2 cases. Patients had no heart failure after surgery, pregnancy and childbirth cardiac function Ⅰ ~ Ⅱ level. Mode of delivery: cesarean section in 11 cases, forceps midwifery in 3 cases, fetal suction head midwifery in 2 cases, normal in 9 cases. 18 cases of baby boy delivered, 7 cases of baby girl, all survived, no significant deformity. Conclusions The possibility of pregnancy after cardiac surgery is related to cardiac correction before pregnancy, and the grading of cardiac function after cardiac surgery is another factor that can tolerate pregnancy. If postoperative cardiac function Ⅰ ~ Ⅱ level can safely over pregnancy and childbirth, but should be strengthened in high-risk pregnancy maternal care