Pregnancy outcomes after the Fontan repair
Pregnancy outcomes after the Fontan repair
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DOI：
10.1016/0735-1097(96)00234-3
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发表时间：
1996-09-01
影响因子：
24
通讯作者：
Koos, BJ
中科院分区：
文献类型：
--
作者：
Canobbio, MM;Mair, DD;Koos, BJ
目的：本研究旨在确定妊娠的风险和结局.越来越多的女性Fontan患者达到生育年龄有兴趣生孩子，迄今为止，报告的怀孕数量很少，因此不鼓励怀孕。来自马约诊所和加州大学洛杉矶医学中心Fontan登记处的126例女性患者中有110例回答了邮寄的问卷，另外6例来自其他中心的报告妊娠的患者被确定并进行审查以评估妊娠结局。在参与研究的中心中，共报告了33例单心室心脏病Fontan手术后妊娠，其中14例母亲有15例（45%）活产，其中13例自然流产，5例选择性终止妊娠。在14例活产妇女中，手术至妊娠的中位年数为4年（范围2 - 14），这些孕妇中报告的孕前问题包括1例患者的心房黄油和1例患者的心室功能障碍、主动脉瓣反流和房室瓣反流，1例患者在妊娠期间发生室上性心动过速并转为窦性心律，分娩期间未报告母体心脏并发症，分娩或产后立即。有6名女性和9名男性婴儿（平均胎龄36.5周;中位体重2，344 g），1名婴儿患有房间隔缺损，随访时，母亲和婴儿均存活良好。Fontan手术后的妊娠似乎在14名孕妇中的13名中耐受良好，流产的风险似乎确实增加，常规阻止妊娠的倾向可能需要重新考虑。
Objectives, This study sought to determine risks and outcome of pregnancy andBackground. Increasingly, female Fontan patients reaching child-bearing years are interested in having children, To date, the number of reported pregnancies is small, and pregnancy has therefore been discouraged.Methods. One hundred ten of 126 female patients from the Fontan registries of the Mayo Clinic and University of California Los Angeles Medical Center responded to a mailed questionnaire, An additional six patients with a reported pregnancy from other centers were identified and reviewed to assess pregnancy outcomes.Results. Among the participating centers, a total of 33 pregnancies after Fontan operation for various types of univentricular heart disease were reported, There were 15 (45%) live births from 14 mothers, with 13 spontaneous abortions and 5 elective terminations, In the 14 women with live births, the median number of years between operation and pregnancy was 4 (range 2 to 14), Reported prepregnancy problems in these gravidas included atrial butter in one patient and ventricular dysfunction, aortic regurgitation and atrioventricular valve regurgitation in another, One patient developed supraventricular tachycardia during pregnancy and had conversion to sinus rhythm, No maternal cardiac complications were reported during labor, delivery or the immediate puerperium. There were six female and nine male infants (mean gestational age 36.5 weeks; median weight 2,344 g), One infant had an atrial septal defect, At follow-up, mothers and infants were alive and well.Conclusions. Pregnancy after the Fontan operation appears to have been well tolerated in 13 of 14 gravidas, There does appear to be an increased risk of miscarriage, The tendency to routinely discourage pregnancy may need to be reconsidered.