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Multi-disciplinary team improving the outcomes of pregnancy with heart disease

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Journal Title:
China Clinical Practical Medicine
Key Word:
多学科协作诊疗模式;妊娠;心脏病;分娩;Multi-disciplinary team;Pregnancy;Heart disease;Delivery

Abstract´╝Ü Objective:To analyze the clinical data of pregnant women with heart disease who participated in multi-disciplinary team(MDT)consultation during pregnancy and perinatal period in the The General Hospital of Northern Theater, to summarize the experience of diagnosis and treatment.Methods:This study was a retrospective study, a total of 162 female pregnant patients with pregnancy complicated with heart disease who participated in MDT consultation of maternal and fetal heart disease during pregnant and puer-peral period in General Hospital of Northern Theater Command from January 2018 to December 2020 were selected, among which 120 patients were continuously followed up and operated in department of Obstetrics and Gynecology and Cardiovascular Surgery of General Hospital of Northern Theater Command, and the remaining 42 patients were transferred to local hospitals for further diagnosis and treatment.The 120 patients with pregnancy complicated with heart disease were included in the study, with the age(29.47±4.54)years old, ranged from 19 to 47 years old.Types of disease complicated with heart disease, cardiac function grades, pregnancy risk grades of heart disease, delivery outcomes and others were analyzed retrospectively.Results:Congenital heart disease was 58.3%(70/120), arrhythmia without cardiac structural abnormality was 30.0%(36/120), valvular heart disease was 8.4%(10/120), primary pulmonary hypertension was 1.7%(2/120), hypertensive disorders in pregnancy was 0.8%(1/120), perinatal cardiomyopathy was 0.8%(1/120).Cardiac function grade Ⅰ was 67.5%(81/120), cardiac function grade Ⅱ was 19.1%(23/120), cardiac function grade Ⅲ was 6.7%(8/120), and cardiac function grade Ⅳ was 6.7%(8/120).The pregnancy risk classification of heart disease: grade Ⅰ was 23.3%(28/120), grade Ⅱ was45.8%(55/120), grade Ⅲ was14.2%(17/120), grade Ⅳwas 10.8%(13/120), and grade Ⅴ was 5.9%(7/120).live birth was 89.2%(107/120), iatrogenic fetal loss was 10.8%(13/120).Conclusions:Patients with heart disease in pregnancy should be treated, diagnosed and intervened as early as possible.The multi-disciplinary model brings together doctors from different disciplines to carry out pre-pregnancy evaluation, pregnancy monitoring, delivery and postpartum management for patients, so as to ensure the safety of mothers and children of patients with heart disease in pregnancy to the greatest extent.

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