Pregnancy Considerations in the Multidisciplinary Care of Patients with Pulmonary Arterial Hypertension.
Pregnancy Considerations in the Multidisciplinary Care of Patients with Pulmonary Arterial Hypertension.
复制标题
肺动脉高压患者的多学科护理中的怀孕考虑。
DOI：
10.3390/jcdd9080260
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发表时间：
2022-08-11
影响因子：
2.4
通讯作者：
中科院分区：
文献类型：
--
作者：
肺动脉高压（PAH）是一种远端肺血管系统的血管收缩疾病，导致不良的右心重塑。 PAH 患者怀孕与孕产妇高发病率和死亡率以及新生儿和胎儿并发症有关。与妊娠相关的心血管、肺、激素和血栓系统的变化对复杂的 PAH 生理学提出了挑战。由于风险较高，目前根据国际共识指南建议 PAH 患者不要怀孕，但有希望改善结局的迹象，特别是对于病情较轻的患者。对于怀孕的患者，需要在 PAH 专家中心进行多学科护理，包括围产期监测、药物管理、分娩、产后护理和并发症管理。 PAH 患者还需要有关避孕和母乳喂养的针对疾病的咨询。在这篇综述中，我们详细介绍了对 PAH 患者进行多学科护理时的生殖计划、妊娠和分娩的注意事项。
Pulmonary arterial hypertension (PAH) is a vasoconstrictive disease of the distal pulmonary vasculature resulting in adverse right heart remodeling. Pregnancy in PAH patients is associated with high maternal morbidity and mortality as well as neonatal and fetal complications. Pregnancy-associated changes in the cardiovascular, pulmonary, hormonal, and thrombotic systems challenge the complex PAH physiology. Due to the high risks, patients with PAH are currently counseled against pregnancy based on international consensus guidelines, but there are promising signs of improving outcomes, particularly for patients with mild disease. For patients who become pregnant, multidisciplinary care at a PAH specialist center is needed for peripartum monitoring, medication management, delivery, postpartum care, and complication management. Patients with PAH also require disease-specific counseling on contraception and breastfeeding. In this review, we detail the considerations for reproductive planning, pregnancy, and delivery for the multidisciplinary care of a patient with PAH.
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