Heart:瓣膜疾病女性的妊娠结局

2020-02-15 xing.T MedSci原创

由此可见,中度/重度MS和AS的女性具有不良的孕产妇和胎儿/新生儿结局风险。他们应由具有妊娠和心脏病经验的团队进行孕前咨询和怀孕护理。

近日,心脏病领域权威杂志Heart上发表了一篇研究文章,研究人员旨在对来自中等/较高人类发展指数(HDI)国家的中度/重度瓣膜性心脏病(VHD)孕妇的母亲/胎儿结局进行系统回顾和荟萃分析。

研究人员检索了OvidSP平台数据库(检索时间1985年1月至2019年1月),以确定报告中度/重度VHD妇女的妊娠结局的研究。孕产妇的主要结局是孕产妇死亡率。胎儿/新生儿的主要结局是死产和新生儿死亡。研究人员只从二尖瓣狭窄(MS)或主动脉瓣狭窄(AS)患者的研究中计算出孕产妇/胎儿结局的合并发生率和95%的置信区间(CI)。

研究人员纳入了包含646名孕妇的十二项研究。严重MS的孕妇死亡率为3%(95%CI为0%–6%),肺水肿为37%(23%–51%)和新发/复发性心律不齐为16%(1%–25%)。死产、新生儿死亡和早产率分别为4%(1%–7%)、2%(0%–4%)和18%(7%–29%)。中度MS患者的死亡率为1%(0%–2%),肺水肿为18%(2%–33%),新发/复发性心律不齐为5%(1%–9%),死产为2%(1%–4%)和早产为10%(2%–17%)。严重AS的孕妇的死亡率为2%(0%–5%),肺水肿为9%(2%–15%),新发/复发性心律失常为4%(0%–7%)。死产、新生儿死亡和早产率分别为2%(0%–5%)、3%(0%–6%)和14%(4%–24%)。中度AS尚无母婴死亡的报道,但是孕妇经历了肺水肿(8%; 0%–20%)、新/复发性心律不齐(2%; 0%–5%)和早产(13%; 6%–20%)。

由此可见,中度/重度MS和AS的女性具有不良的孕产妇和胎儿/新生儿结局风险。他们应由具有妊娠和心脏病经验的团队进行孕前咨询和怀孕护理。

原始出处:

Robin Alexandra Ducas.et al.Pregnancy outcomes in women with significant valve disease: a systematic review and meta-analysis.heart.2020.http://dx.doi.org/10.1136/heartjnl-2019-315859

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    2020-02-17 zhaojie88
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    2020-02-17 slcumt
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