OBSTRUCTIVE SLEEP-APNEA DURING PREGNANCY - THERAPY AND IMPLICATIONS FOR FETAL HEALTH
OBSTRUCTIVE SLEEP-APNEA DURING PREGNANCY - THERAPY AND IMPLICATIONS FOR FETAL HEALTH
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DOI：
10.1164/ajrccm/144.2.461
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发表时间：
1991-08-01
期刊：
影响因子：
--
通讯作者：
LEVY, RD
中科院分区：
文献类型：
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作者：
CHARBONNEAU, M;FALCONE, T;LEVY, RD
一名32岁的妇女在她怀孕的最后三个月被发现有严重的阻塞性睡眠呼吸暂停（OSA）。夜间多导睡眠图显示呼吸暂停加呼吸不足指数为每小时159次。呼吸暂停与快速眼动睡眠期间严重氧饱和度下降至40%、母体心动过缓和二度心脏传导阻滞相关。体外心脏分娩描记术显示胎儿心率对胎动的反应正常，即使在呼吸暂停和氧饱和度下降时也是如此。经鼻持续气道正压通气（15 cm H2O）可有效治疗呼吸暂停和血氧饱和度下降，对胎心率无影响。患者在妊娠第39周选择性引产，产下一名生长迟缓的新生儿。早期识别和治疗妊娠期OSA可能会预防胎儿发育问题。
A 32 yr-old woman in her last trimester of pregnancy was found to have severe obstructive sleep apnea (OSA). The overnight polysomnogram demonstrated an apnea plus hypopnea index of 159 events per hour. Apneas were associated with severe oxygen desaturation to 40% during rapid eye movement sleep, maternal bradycardia, and second degree heart block. External cardiotocography showed normal fetal heart rate reactivity to fetal movements, even during the apneas and episodes of oxygen desaturation. Nasal continuous positive airway pressure at a level of 15 cm H2O effectively treated the apneas and desaturation and had no effect on the fetal heart rate. The patient was induced electively during the 39th wk of pregnancy and gave birth to a newborn with growth retardation. Early recognition and treatment of OSA in pregnancy might prevent problems with fetal development.