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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 47-48页

作者： Veldtman G.R. Connolly H.M. Grogan M. 高登峰 div. cardiova sc. dis. and int. med. Mayo Clinic Rochester MN United StatesDr.

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 cardiovasc.lar 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.

关键词：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

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