妊娠相关性心衰
急性心衰、急性肺水肿、心源性休克
慢性心衰
左心衰
全心衰（右心受累）
恶性心律失常
血栓栓塞（心室附壁血栓）等
49 patients with newlydiagnosed PPCM and LVEF≤35% receiving a WCD were included in this retrospectiveanalysis.
Mean follow-up was15±10 month
Mean wear time was120±106 days
Six (12%) patients presentedeight ventricular tachyarrhythmias during WCD period: five episodes of VF, two sustainedventricular tachycardia (VT) and one nonsustained VT occurred.
A WCD should be consideredfor 3–6 months in these patients to prevent sudden cardiac death fromventricular tachyarrhythmias.
溴麦角环肽 2.5mg BID for 14d 2.5mg qd 15-56d,同时抗凝治疗
免疫球蛋白静脉滴注
乙酮可可碱:400mg TID 6 月
高血压妊娠相关性心衰（HHFP）
➤ The diagnosis of HHFP was based on thepresence of clinical heart failure associated with any form of hypertension(chronic hypertension, gestational proteinurichypertension, preeclampsia, eclampsia and postpartum hypertension)
➤ between thelast month of pregnancy and the first 5 months of the postpartum
➤ in the absence of pre-existing heartdisease, and any other identifiable cause of peripartum heartfailure besides hypertension.
溶血，血小板减少，肝酶增高
与溶血性尿毒症性综合征有关
病因不清楚，补体激活参入
Ham test （C5b-9)
Eculizumab. 补体抑制剂体外研究可能有效
其他心脏病合并心衰
妊娠前心脏病约1%
妊娠期第二大死因
发达国家:先天性心脏病
死因：MI，主动脉夹层，心肌病猝死
发展中国家:88-90%风湿性瓣膜病
Women with mild and asymptomatic mitral valve diseasetolerate pregnancy well with few complications
Mitral stenosis was less well tolerated than mitral regurgitation, resultingin high rates of heart failure and need for hospitalization.
Rates of heart failure were highest in severe mitral stenosis (49.1%) and moderate mitral stenosis
Symptomatic mitral stenosis was also found to be an independent predictor of maternaladverse cardiac events.
Women with mixed moderate to severe regurgitation and stenosis had baseline characteristicsand adverse pregnancy outcomes similar to those with severe mitral stenosis.
Severe mitral stenosis is an independent risk factor for adverse fetal outcomes,including preterm birth and low birth weight
Given the high rate of complications during pregnancy, a percutaneous balloon mitral commissurotomy, whichhas a low risk, may be a feasible treatment for young women with moderate orsevere mitral stenosis who have a desire for pregnancy, even if they areasymptomatic.
