妇产科学--Pregnancy Complicating.pptVIP

Pregnancy complicating with cardiac disease Incidence rate：1%-4% Mortality rate：0.5-1％ the second reason leaded to maternal mortality entity Congenital cardiac disease Rheumatic heart disease Viral myocarditis and myocarditis sequelae cardiac disease based on gestational hypertension disease peripartum cardiomyopathy 1. Congenital cardiac disease right-left shunt——cyanotic heart disease eg: Fallot tetralogy， Eisebmenger syndrome pregnancy is contraindicated, and therapeutic abortion is advised if contraception fails left to right shunt——non-cyanotic heart disease eg: atrial septal defect，interventricular septal defect，patent ductus arteriosus small——pregnancy is well tolerance large——pulmonary artery hypertension， right-left shunt，cyanosis Non-shunt pulmonic stenosis， oarctation of aorta， Marfans syndrome 2. rheumatic heart disease mitral valve stenosis Combination of valvular heart disease eg ：aortic valve stenosis, aortic valve incompetence , mitral incompetence 3. Viral myocarditis and myocarditis sequelae source of infection：enteric virus，Coxsackie virus，Rubella virus，cytomegalovirus diagnosis： history of respiratory tract or alimentary infection； arhythmia、cardiac dilatation、 degrade of myocardial contractility and even heart failure after two-three weeks Not cure with disease for six months——myocarditis sequelae acute myocarditis cured——keep on pregnancy 4. cardiac disease based on gestational hypertension disease Sys. small blood vessel spasm——cardiac muscle ischemic hypoxia，cell damaged——contraction force weaken —— heart failure fluid replacement and expansion—— circulation volume increased——heart failure peripartum cardiomyopathy, PPCM etiology unknown Without heart disease history before pregnancy From 28 gestational weeks to 6 months after parturition dilated cardiomyopathy clinical manifestation：dyspnea，thoracalgia，edema，hepatomegaly signs：heart dilatation，lung con