法洛四联症妇女的妊娠预后

作     者：Veldtman G.R. Connolly H.M. Grogan M. 高登峰 

作者机构：Div. Cardiova sc. Dis. and Int. Med. Mayo Clinic Rochester MN United StatesDr. 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第1卷第1期

页      面：47-48页

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：妊娠预后 法洛四联症 婴儿出生体重 肺动脉高压 先天性畸形 收缩功能障碍 左室功能不全 流产率 血流动力学 右室功能 

摘      要：Objectives We sought to determine pregnancy outcomes in patients with t etralog y of Fallot (TOF). Background Pregnancy outcomes in patients with TOF are incomp letely defined. Methods Clinical, hemodynamic, and obstetric data were reviewed for women with TOF and prior pregnancy. Results Of 72 respondents, 43 (mean age, 26 years) had 112 pregnancies (range, 1 to 5); 82 pregnancies were successful. Eight women had unrepaired TOF at the time of their 20 successful pregnancies. A t first assessment (age ≥18 years), six patients had pulmonary hypertension, th ree had moderate or severe right ventricular (RV) systolic dysfunction, and 13 h ad severe RV dilation due to pulmonic regurgitation. Sixteen patients had 30 mis carriages(27%) and one term stillbirth. Mean overall birth weight was 3.2 kg (r ange, 2.1 to 4.2 kg). Unrepaired TOF (p=0.05) and morphologic pulmonary artery a bnormality (p=0.03) were independently predictive of infant birth weight. Six pa tients had cardiovascular complications during pregnancy: supraventricular tachy cardia in two, heart failure in two, pulmonary embolism in a patient with pulmon ary hypertension, and progressive RV dilation in a patient with severe pulmonic regurgitation. Five infants (6%) had congenital anomalies. Conclusions Patients with TOF have an increased risk of fetal loss, and their offspring are more lik ely to have congenital anomalies than offspring in the general population. Adver se maternal events, although rare, may be associated with left ventricular dysfu nction, severe pulmonary hypertension, and severe pulmonic regurgitation with RV dysfunction.