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目的:了解妊娠合并心衰对母儿的危害,探讨妊娠合并心衰四种不同发病原因与妊娠结局的关系。方法:回顾性分析2004年12月～2007年9月广州市重症孕产妇救治中心收治的54例妊娠期心力衰竭患者,对其发病原因及妊娠结局进行分析。结果:妊娠期高血压疾病性心脏病发生心衰者34例(62.96%),妊娠合并风湿性心脏病8例(14.81%),围产期心肌病7例(12.96%),妊娠合并甲亢性心脏病5例(9.25%)。其终止妊娠的时间分别是(33.26±2.66)周、(32.46±5.97)周、(37.22±4.88)周、(36.34±4.67)周。孕产妇死亡2例(3.70%),新生儿死亡9例(16.66%)。结论:妊娠合并心力衰竭的病因中以妊娠期高血压疾病最为常见;妊娠合并风湿性心脏病的产妇以及胎儿的预后最差,早产率高;围生期心肌病以及甲亢性心脏病如果控制及时,新生儿的预后较好。所以明确妊娠合并心力衰竭的原因,对及时正确处理妊娠合并心力衰竭,有利于降低围产期孕产妇和围产儿的死亡率。
Objective: To understand the risk of pregnancy complicated with heart failure on pregnant women and children, to explore the relationship between pregnancy causes and four different causes of pregnancy complicated with heart failure. Methods: A retrospective analysis of 54 cases of gestational heart failure admitted to Guangzhou Severe Maternity and Child Welfare Center from December 2004 to September 2007 was conducted to analyze the causes and the outcome of pregnancy. Results: 34 cases (62.96%) had heart failure with hypertensive disorder complicating pregnancy, 8 cases (14.81%) with rheumatic heart disease in pregnancy, 7 cases (12.96%) with perinatal cardiomyopathy, hyperthyroidism with pregnancy 5 cases of heart disease (9.25%). The time of termination of pregnancy were (33.26 ± 2.66) weeks, (32.46 ± 5.97) weeks, (37.22 ± 4.88) weeks and (36.34 ± 4.67) weeks, respectively. Maternal death in 2 cases (3.70%), neonatal death in 9 cases (16.66%). Conclusions: The most common cause of pregnancy-induced hypertension is pregnancy and heart failure. Maternal and fetus with pregnancy-associated rheumatic heart disease have the worst prognosis and high preterm birth rate. Perinatal cardiomyopathy and hyperthyroid heart disease are controlled in time , The prognosis of newborns is better. Therefore, a clear reason for pregnancy complicated with heart failure, timely and correct treatment of pregnancy complicated with heart failure, help to reduce perinatal maternal and perinatal mortality.