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1.北部战区总医院妇产科,辽宁 沈阳 110003
2.义乌市中心医院妇产科,浙江 义乌 322000
3.昌乐县人民医院妇产科,山东 潍坊 262400
曲冬颖,E-mail:38080806@qq.com
收稿:2025-08-15,
纸质出版:2026-03-25
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张程程,赵勤,张金慧等.不同类型先天性心脏病女性妊娠结局的回顾性研究[J].局解手术学杂志,2026,35(03):245-248.
ZHANG Cheng-cheng,ZHAO Qin,ZHANG Jin-hui,et al.Retrospective study on pregnancy outcomes in women with different types of congenital heart disease[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(03):245-248.
张程程,赵勤,张金慧等.不同类型先天性心脏病女性妊娠结局的回顾性研究[J].局解手术学杂志,2026,35(03):245-248. DOI: 10.11659/jjssx.08E025062.
ZHANG Cheng-cheng,ZHAO Qin,ZHANG Jin-hui,et al.Retrospective study on pregnancy outcomes in women with different types of congenital heart disease[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(03):245-248. DOI: 10.11659/jjssx.08E025062.
目的
2
探究不同类型先天性心脏病(CHD)女性的妊娠结局及其影响因素。
方法
2
回顾性分析2017年1月至2023年12月在北部战区总医院就诊的148例妊娠合并CHD患者的临床资料,根据CHD类型分为简单CHD组(
n
=64例)和复杂CHD组(
n
=84)。收集患者的一般资料、临床资料及妊娠结局,探讨妊娠结局的影响因素,并分析手术修复对妊娠结局的影响。
结果
2
患者经多学科团队管理未发生孕产妇及新生儿死亡。复杂CHD组患者抗凝治疗比例高于简单CHD组(
P
<
0.05),住院时间长于简单CHD组(
P
<
0.05)。简单CHD主要为左向右分流型59例(92.19%);复杂CHD类型分布广泛,其中左向右分流型合并先天性心脏瓣膜病31例(36.90%),单纯先天性心脏瓣膜病23例(27.38%),右向左分流型13例(15.48%),特殊类型15例(17.86%)。简单CHD组患者纽约心脏协会分级(NYHA)Ⅰ级比例高于复杂CHD组(
P
<
0.05)。简单CHD组患者流产发生率低于复杂CHD组,经阴道分娩比例高于复杂CHD组,差异均有统计学意义(
P
<
0.05)。复杂CHD组患者肺动脉高压和心律失常发生率、早产儿及低出生体质量儿出生率显著高于简单CHD组(
P
<
0.05)。未手术修复的复杂CHD患者肺动脉高压和早产的发生风险显著高于手术修复患者。
结论
2
复杂CHD患者妊娠期心脏并发症和新生儿不良结局的发生风险显著高于简单CHD患者。手术修复可降低复杂CHD患者肺动脉高压和早产的发生风险。多学科团队管理对改善CHD患者妊娠结局具有重要意义。
Objective
2
To investigate the pregnancy outcomes in women with different types of congenital heart disease (CHD), and its influencing factors.
Methods
2
A retrospective study was conducted on the clinical data of 148 pregnant women with CHD who were treated in General Hospital of Northern Theater Command from January 2017 to December 2023. The patients were divided into the simple CHD group (
n
=64) and the complex CHD group (
n
=84) according to the type of CHD. The general information, clinical data, and pregnancy outcomes of the patients were collected, the influencing factors of pregnancy outcomes were investigated, and the impact of surgical repair on pregnancy outcomes was analyzed.
Results
2
No maternal or neonatal deaths occurred under multidisciplinary team management. The complex CHD group had a higher proportion of patients receiving anticoagulant therapy and a longer hospital stay compared to the simple CHD group (
P
<
0.05). Simple CHD was predominantly left-to-right shunt type in 59 cases (92.19%). Complex CHD types were widely distributed, including left-to-right shunt combined with congenital valvular heart disease in 31 cases (36.90%), isolated congenital valvular heart disease in 23 cases (27.38%), right-to-left shunt in 13 cases (15.48%), and special types in 15 cases (17.86%). Patients in the simple CHD group had a significantly higher proportion of New York Heart Association (NYHA) class Ⅰ than those in the complex CHD group (
P
<
0.05). The incidence of abortion in the simple CHD group was lower than that in the complex CHD group, while the rate of vaginal delivery was higher than that in the complex CHD group, with statistically significant differences (
P
<
0.05). The incidences of pulmonary hypertension and arrhythmia, as we
ll as the rates of preterm birth and low birth weight in the complex CHD group were significantly higher than those in the simple CHD group (
P
<
0.05). Among patients with complex CHD, those without surgical repair had significantly higher risks of developing pulmonary hypertension and preterm birth than those receiving surgical repair.
Conclusion
2
Patients with complex CHD have significantly higher risks of cardiac complications and adverse neonatal outcomes during pregnancy compared to those with simple CHD. Surgical repair can reduce the risk of pulmonary hypertension and preterm birth in patients with complex CHD. Multidisciplinary team management is crucial for improving pregnancy outcomes in patients with CHD.
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