| Abnormal development of heart and blood vessels in embryo with the result that defect of heart and cardiac vessels is called congenital heart disease (CHD).According to the WHO,in every kinds of congenital abnormal dead cases,the malformations of cardiac vascular is above 40%, which is the commonest malformation of mankind defects.The mortality of CHD is about 6‰-8‰ in living neonatal,probably 100,000-200,000 CHD infants are born in our country every year.Pregnancy complicating CHD is one of the main reasons that cause the death of pregnant women, and CHD is the first reason of the death of children below 5 years old, so CHD is one of the malformations that seriously endanger the health of pregnant women and children.In order to explore the effect of CHD to pregnant women and children,we analyzed the clinical characters of 26 cases of pregnancy complicating CHD from 1991.1 to 2004.2 and 62 cases of 0-6 years old CHD children from 1992.1 to 2004.2 in the first hospital of Jinlin University.Results showed:The poor heart functional capacity of pregnant women influences the growth of neonatal.While the heart functional capacity is above class â…¡,the weight and BPD of neonatal are below of control and class â… group, Apgar score is lower than control(P≤0.05);in addition,the incidence of IUGR,intrauterine distress,premature labor and death of fetus is obviously higher than control.10 cases(38%)are belong to the high dangerous grade and 5-15% mortality group of CHD,according to the pathologic types.4 cases present clinical manifestations of heart failure in peri-parturition.But promptly and properly treatments have been done,none died.The ability of bearing labor is poor of these women, the ratio of caesarean birth is obviously higher than control(P≤0.05). The heart functional capacity was better in them that were corrected by surgical operation,and the ability of bearing labor is improved, but the ratio of caesarean section was higher in patients without operational treatment(P>0.05).The infection ratio of pregnancy complicating CHD women is higher than control after caesarean section. In addition,the pregnant women that heart functional capacity is aboving class â…¢ were required to refuse breast feeding their babies after labor.All cases underwent perinatal period safely.The genesis of CHD is associated with pregnancy infection and heritance.44% mother of CHD children underwent abnormal process in gestation.The ratio of VSD and ASD is 27% and 18% in CHD children,respectively.87.5% complex CHD was concentrated in 0-12 months old infants,with the growth of children,its ratio is reduced.Besides fast heart rate,90.5% CHD children presented cardiac murmurs,and 52% with cyanose and hastily breath after sucking milk,crying or movement.They often appear complications of congestive heart failure or bronchopneumonia that is hamful to their health.The serious CHD children mostly died in neonatal period,the mortality of 0-12 months old CHD children is obviously higher than 1-6 years old children(P≤0.05).Surviving children have better heart functional capacity.These results suggested:The poor heart functional capacity of pregnant woman influences the development of neonatal.The prognosis of high dangerous grade and 5-15% mortality group showed that,if the obstetrician strengthen the management of perinatal period,the mortality will drop apparent in it.These pregnant women with CHD have better heart functional capacity after correcting of surgical operation,their prognosis of pregnancy is good.Improving heart functional capacity,taking caesarean section at right moment, reinforcing treatment of perinatal period,we can raise the survival ratio of them evidently.If CHD women attempt to pregnancy,they should first be evaluated whether they could bear pregnancy and whether there have dangerous elements effecting health of mothers and fetus.If better evaluation and proper nursing could have been done,the risk of pregnancy complicating CHD would reduced remarkably.The pregnancy infection and heritance are the major r... |
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