The Clinical Analysis Of Delivery Mode And Perinatal Outcome In Pregnant Women With Heart Disease

Objective:Identify the incidence of pregnant women with heart disease in the Obstetrics in First Hospital of Shanxi Medical University through retrospective analysis;compare different types of heart disease,different cardiac function level in patients with different mode of delivery and perinatal outcome,to investigate the influence of types of heart disease,cardiac function level on pregnancy outcome.Provide theory basis for clinical consultation and treatment.Method:Reviewed the delivery records of 128 pregnant women with heart disease in the Obstetrics in First Hospital of Shanxi Medical University from January 2004 to June 2008,group is divided into different types of heart disease,different cardiac function levels,study the pregnancy outcome,analyzed the data with statistic software.Result:①The incidence of pregnant women with heart disease,4.25%in 2004,4.51%in 2005, 2.36%in 2006,1.70%in 2007,2.69%in 2008.②In 128 patients,there were 45 congenital heart disease(35.16%),14 rheumatic heart disease(10.94%),34 arrhythmia(28.91%),5 peripartum cardiomyopathy(3.91%),4 anemic heart disease(3.13%),6 HDCP-induced heart disease(4.96%),17 others(13.28%).③In 121 delivered women,16 vaginal delivery(13.22%),105 cesarean section(86.78%)which was higher than vaginal delivery,the difference was significant.④43.80%cesarean section was influenced by social factors,which needs more attention.⑤The gestational age,weight,Apgar score in cardiac function levelⅢ～Ⅳwere lower than that in levelⅠ～Ⅱ,the rate of premature delivery,fetal distress,fetal death,Fetal Growth Restriction were higher than that in levelⅠ～Ⅱ,the differences were significant.Conclusion:The incidence of pregnant women with heart disease was the same with related reports.Cesarean section rate is higher than the rate of vaginal delivery in these patients,cardiac function levelⅢ～Ⅳshould do cesarean section.The gestational age,weight,Apgar score in cardiac function levelⅢ～Ⅳwere lower than that in levelⅠ～Ⅱ,the rate of premature delivery,fetal distress,fetal death,Fetal Growth Restriction were higher than that in levelⅠ～Ⅱ,the differences were significant.This study suggests that we should strengthen the science education,raise the awareness of heart disease in pregnancy,strengthen antenatal examination and perinatal care,emphasis on interdisciplinary cooperation,timely and proper termination of pregnancy,reduce maternal mortality and perinatal death rate.