ヒト心房性ナトリウム利尿ペプチド連続投与と連続心拍出量測定で分娩・産褥を管理した僧帽弁狭窄症合併妊娠の1例

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We reported the case of a 36-year-old Chinese woman complicated with severe mitral stenosis who delivered a term healthy baby twice. During her 1st pregnancy she suffered from hypovolemic heart failure in puerperium, partly because of lack of cardiac function monitoring. She subsequenty returned to China but did not under go the surgical repair that was medically indicated. During the 2nd pregnancy, the severity of mitral stenosis was same as during the 1st pregnancy, and her antepartum course was uneventful. Cesarean section was carried out at 37 weeks' gestation. We continuously monitored her cardiac functions including the cardiac index, cantral venous pressure and pulmonary wedge pressure throughout early puerperium. We also used human atrial natriuretic peptide to control her blood pressure and diuretics. These managements enabled us to successfully care for her during her 2nd pregnancy complicated with severe mitral stenosis.
社団法人日本産科婦人科学会の論文
2000-09-01