ACOG Practice Bulletin No. 212: Pregnancy and Heart Disease.
ACOG Practice Bulletin No. 212: Pregnancy and Heart Disease.
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DOI：
10.1097/aog.0000000000003243
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发表时间：
2019-05-01
影响因子：
7.2
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中科院分区：
文献类型：
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孕产妇心脏病已成为安全孕产和妇女长期心血管健康的主要威胁。在美国，心脏和血管系统的疾病和功能障碍，即“心血管疾病”，现在是孕妇和产后妇女死亡的主要原因（），占每10万例活产死亡4.23例，几乎是联合王国的两倍（）。最新数据表明，心血管疾病占美国妊娠相关死亡的26.5%（）。进一步令人关切的是心血管疾病结果的差异，非白人和低收入妇女的发病率和死亡率较高。促成因素包括孕前心血管疾病评估的障碍，产前护理期间错过了识别心血管疾病风险因素的机会，高风险分娩期护理的差距，以及产褥期心血管疾病症状的识别延迟。本文件的目的是：1）描述心脏病在孕妇和产后妇女中的患病率和影响; 2）为产前和产后早期风险因素的识别和调整提供指导; 3）概述导致妊娠期和产褥期发病率和死亡率的常见心血管疾病; 4）描述对已有或新发获得性心脏病的孕妇和产后妇女的护理建议; 5）为心脏病妇女提供全面的解释性护理计划。
Maternal heart disease has emerged as a major threat to safe motherhood and women's long-term cardiovascular health. In the United States, disease and dysfunction of the heart and vascular system as "cardiovascular disease" is now the leading cause of death in pregnant women and women in the postpartum period () accounting for 4.23 deaths per 100,000 live births, a rate almost twice that of the United Kingdom (). The most recent data indicate that cardiovascular diseases constitute 26.5% of U.S. pregnancy-related deaths (). Of further concern are the disparities in cardiovascular disease outcomes, with higher rates of morbidity and mortality among nonwhite and lower-income women. Contributing factors include barriers to prepregnancy cardiovascular disease assessment, missed opportunities to identify cardiovascular disease risk factors during prenatal care, gaps in high-risk intrapartum care, and delays in recognition of cardiovascular disease symptoms during the puerperium. The purpose of this document is to 1) describe the prevalence and effect of heart disease among pregnant and postpartum women; 2) provide guidance for early antepartum and postpartum risk factor identification and modification; 3) outline common cardiovascular disorders that cause morbidity and mortality during pregnancy and the puerperium; 4) describe recommendations for care for pregnant and postpartum women with preexisting or new-onset acquired heart disease; and 5) present a comprehensive interpregnancy care plan for women with heart disease.