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妊娠合并心脏病上海市区11所医院1975～1984年十年中共分娩314,862人次,其中心脏病孕妇2,696例次,发病率为0.856％,死亡7例,死亡率为0.26%。妊娠合并心脏病的发生率有逐年上升的趋势。前五年平均发病率为0.64％,后五年为1.02％,这主要是由于诊断技术的提高和先天性心脏病、心肌炎等发病率增加之故。1983年妊娠合并心脏病死亡共10例,占同期孕产妇死亡总人数的1/4,而其中7例孕期已超过32周,如能在重点监护下进行计划分娩,其中可能有的可以得到挽救。心脏病主要是风湿性心脏病(以下简称风心)和先天性心脏病(先心),二者的比例有显著改变。即风心的比例在减少,而先心的比例在上升。但从实际检查确诊的数字来看,后五年比前五年均有增加。风心的发病率自0.156％上升至0.256％,先心自0.115％上升至0.354％,而心肌炎和心律不齐增加更多。一、心衰问题心衰直接威胁母儿生命。通过资料分析,心功能Ⅰ、Ⅱ级发生心衰的发病率为2.78%,而Ⅲ、Ⅳ级的则高达52.17％。此外,心衰病例中,风心占56.4％,先心占41％。心衰发生时间有84.6％在产前,产后也有10.3％。因此,心功能Ⅲ、Ⅳ级者不宜怀孕,如怀孕
Pregnancy with Heart Diseases In 11 hospitals in Shanghai area, 314,862 Chinese were delivered in the decade from 1975 to 1984, of which 2,696 were pregnant women with heart disease. The incidence rate was 0.856%. There were 7 deaths and the death rate was 0.26%. The incidence of pregnancy complicated with heart disease is increasing year by year. The average incidence of the first five years was 0.64% and 1.02% in the next five years, mainly due to the increased diagnostic skills and increased incidence of congenital heart disease and myocarditis. In 1983, there were 10 deaths from pregnancy complicated by heart disease, accounting for 1/4 of the total number of maternal deaths in the same period. Among them, 7 had been in pregnancy for more than 32 weeks. If planned delivery could be under intensive supervision, some may be saved . Heart disease is mainly rheumatic heart disease (hereinafter referred to as wind heart) and congenital heart disease (congenital heart), a significant change in the ratio between the two. That is, the proportion of the wind is decreasing, while the proportion of the heart is rising. However, according to the actual number of confirmed diagnoses, the latter five years have all increased over the previous five years. The incidence of rheumatoid increased from 0.156% to 0.256%, heart rate increased from 0.115% to 0.354%, while myocarditis and arrhythmia increased more. First, the problem of heart failure Heart failure directly threaten mother’s life. According to the data analysis, the incidence of heart failure with heart function Ⅰ and Ⅱ level was 2.78%, while that of Ⅲ and Ⅳ level was as high as 52.17%. In addition, heart failure cases, wind heart accounted for 56.4%, heart rate accounted for 41%. 84.6% of the time of heart failure occurred in prenatal and postpartum 10.3%. Therefore, heart function Ⅲ, Ⅳ grade should not be pregnant, such as pregnancy