Significance Of Pregnancy Risk Grading For The Adverse Outcomes Of Patients With Heart Disease In Pregnancy

Objective:Explore the difference in the occurrence of adverse maternal and child outcomes in patients with pregnancy complicated by heart disease in different types of heart disease,cardiac function status and pregnancy risk classification,and assess the value of pregnancy risk grading for adverse maternal and child outcomes.Methods:The data of 182 pregnant women with heart disease from January 1,2019 to December 31,2019 were divided into groups by type of heart disease,cardiac function status,and pregnancy risk classification to study their pregnancy outcomes,and compare the occurrence of adverse maternal and child outcomes within the group.The ROC curve analysis was also made on the evaluation value of pregnancy risk classification and cardiac function status to adverse maternal and fetal outcomes.Results:1.Among the disease types of pregnant women with heart disease,the incidence of congenital heart disease is the highest(72 cases,39.56%),followed by arrhythmia(47cases,25.82%),and valvular heart disease is the third(31 cases,17.03%).The incidence of pregnancy-specific hypertensive heart disease and perinatal cardiomyopathy is low,but the incidence of adverse maternal and child outcomes is high.There were statistically significant differences in premature birth,neonatal asphyxia,intrauterine growth restriction,and maternal death among various heart disease types(P<0.05).There was no significant difference in the incidence of low birth weight infants.(P>0.05).2.NYHA heart function class Ⅲ ～ Ⅳ patients,the incidence of premature birth,low birth weight infants and maternal preeclampsia,HELLP syndrome,etc.have significantly increased,which is significantly higher than that of NYHA heart function class Ⅰ～Ⅱ Sexual difference(P< 0.05),the gestational week of delivery and the weight of newborns in NYHA heart function classⅠ～Ⅱwere higher than those in NYHA heart function class Ⅲ～Ⅳ(P<0.05).3.Premature birth,preeclampsia,low birth weight infants,fetal intrauterine growth restriction,etc.have significant differences in different pregnancy risk classifications(P<0.05),and the pregnancy risk classification is Ⅳ and Ⅴ group There was a statistically significant difference between the gestational week of delivery and the weight of the newborn and the risk classification of Ⅰ,Ⅱ,and Ⅲ groups(P < 0.05).4.Pregnancy risk classification can better evaluate the occurrence of maternal and child complications.ROC curve analysis found that the area under the curve(AUC)for pregnancy risk classification to evaluate maternal and fetal complications was 0.743,and the AUC for cardiac function classification to evaluate maternal and fetal complications was 0.706.Conclusion:1.The disease types of patients with heart disease in pregnancy have changed compared with the past,and the proportion of patients with congenital heart disease and arrhythmia has increased.2.Pregnancy patients with heart disease have a higher incidence of adverse maternal and child outcomes.Compared with other types of arrhythmia,there are fewer adverse maternal and fetal outcomes,but the management is still standardized,and it is necessary to be alert to its malignant attacks.The incidence of adverse maternal and fetal outcomes in NYHA heart function class Ⅲ～Ⅳ group was higher than that of NYHA heart function class Ⅰ～Ⅱ group,and the gestational week of delivery and the weight of the newborn were lower.The higher the pregnancy risk grade,the higher the incidence of adverse maternal and child outcomes.3.Pregnancy risk classification has a good value in evaluating adverse maternal and child outcomes,and its classification method is objective and specific,easy to grasp,and is a clinical diagnosis and treatment basis that can be used by obstetricians.The application of pregnancy risk classification should be strengthened in clinical work.Patients with heart disease put forward reasonable pregnancy recommendations,and carry out individualized management of patients with heart disease during pregnancy.Multidisciplinary cooperation can effectively improve the prognosis of mothers and children.