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      先天性心脏病能怀孕吗

      【导读】先天性心脏病将患者的心脏强弱分为四个等级,如果是一、二等级的患者一般怀孕没有问题,三级患者原则是不能怀孕,但如果怀孕了也可以在医生指导下妊娠,四级患者就绝对不可以怀孕?;褂泻芏嗷颊叨蓟岬P南忍煨孕脑嗖〉囊糯?,到底患者能不能怀孕?一起看看吧。

      先天性心脏病患者都会担心能不能够怀孕,这其实要视乎患者的病情而言。先天性心脏病将患者的心脏强弱分为四个等级,如果是一、二等级的患者一般怀孕没有问题,三级患者原则是不能怀孕,但如果怀孕了也可以在医生指导下妊娠,四级患者就绝对不可以怀孕。

      如果患者是单纯的先天性心脏病手术治疗后或者是缺损较小者,不用治疗,常规检查后各项指正都在正常范围之内的,能够承受怀孕、妊娠的时候身体的各种负担的就可以在医生的指导下怀孕。

      但是如果是复杂的先天性心脏病、病情比较严重的、不能承受手术治疗的患者,一般不建议怀孕。因为孕妇在怀孕期间,身体的代谢机能会更加旺盛,妊娠期的时候子宫增大更会使心脏负担加重,生产的时候子宫收缩,产妇用力的话心跳加速,产妇回心重量增加,心脏的负担忽然加重,会容易发生心力衰竭的状况。

      另外,也有不少患者担心不能怀孕是因为先天性心脏病是遗传性的,担心会遗传给孩子。其实先天性心脏病不属于遗传性的疾病,但是如果患者有家庭发病趋势的话就要定期做好检查。

      先天性心脏病的症状表现视乎先天性心脏病的类型和病情复杂程度而言。先天性心脏病根可分为这几类:

      无分流类:左右两侧无分流、无紫绀,如肺动脉口狭窄、主动脉狭窄、主动脉缩窄、原发性肺动脉扩张、原发性肺动脉高压或右位心等。

      左至右分流类:在左右心腔或主肺动脉间有异常通道,左侧压力高于右侧,左侧动脉血通过异常通道进入右侧静脉血中。

      右至左分流类:右心腔或肺动脉内压力异常增高,血流通过异常通道流入左心腔或主动脉。

      轻度先天性心脏病患者没有明显的症状。如果是严重患者活动后会出现呼吸困难、晕厥、紫绀甚至休克的症状。另外轻度先天性心脏病患者在儿童时期会经常感冒,容易患有呼吸道感染、支气管炎、肺炎等,生长发育也会比较差、容易疲惫等。

      先天性心脏病的致病原因一般有:

      1、遗传因素:先天性心脏病并不是遗传性的疾病,但是可能由于基因异?;蛉旧寤渌?,5%的先天性心脏病患者发生于同一家族,患者病情相似。

      2、胎儿生存环境因素:如果母体在怀孕的时候孕妇患有糖尿病而未经治疗和控制病情者,胎儿患有先天性心脏病的几率就会上升。同时孕妇如果在妊娠早期接触过一些致畸药物,如锂、苯妥英钠或类固醇等;受到放射性物质如X射线、同位素等过量照射;受到病毒感染等都会提升胎儿先心病的患病率。

      3、其他因素:缺氧可能会导致先天性心脏病的发生,高原地区动脉导管未闭及房间隔缺损发病率较高。有些先天性心脏病还有性别倾向性。

      先天性心脏病不是遗传性的疾病,它的遗传几率是十分低的。遗传的原因一般都是因为家族中有先天性心脏病的遗传史。例如兄弟姐妹同时患先心病、父母与子女同时患先天性心脏病。一般来说,母亲患有先天性心脏病的话,孩子患病的危险性为10%。如果母亲生下的第一胎是患有先天性心脏病的,那么第二胎患病的可能性就会有2%左右,如果两胎都患有先天性心脏病,那么第三胎的患病率就更高,有10%。

      其实为了避免孩子患有先天性心脏病,孕妇在怀孕的时候就要注意几点:

      1、如果患有糖尿病就要及时治疗和控制病情。

      2、在妊娠早期不要接触致畸药物,如锂、苯妥英钠或类固醇等。

      3、妊娠早期不要受到放射性物质如X射线、同位素等过量照射。

      4、避免病毒感染。尤其是怀孕3周-8周,如遭到病毒感染,胎儿易发生心脏血管畸形。

      5、不要近亲婚配。

      6、不烟不酒。

      先天性心脏病有三种治疗方法,治疗的方法要根据病情而定。包括:

      1、药物治疗。

      2、手术治疗。先天性心脏病的外科手术要根据心脏畸形的种类和病情的严重程度等综合因素决定。手术方法可分为:根治手术、姑息手术、心脏移植三种。姑息手术仅能起到改善症状的作用而不能起到根治效果,主要用于目前尚无根治方法的复杂先心病,为根治手术创造条件,如改良Glenn、Fontan手术,或者作为一种预备手术,促使原来未发育完善的结构生长发育,如体—肺分流术等。根治手术可以使患者的心脏解剖回到正常人的结构。心脏移植 主要用于终末性心脏病及无法用目前的手术方法治疗的复杂先心病。

      3、介入治疗。分为两种,一种是用球囊扩张的方法解除血管及瓣膜的狭窄,如主动脉瓣狭窄、肺动脉瓣狭窄、主动脉缩窄等;另一种是利用各种记忆金属材质的特质封堵器堵闭不应有的缺损,如房间隔缺损、室间隔缺损、动脉导管末闭等。介入治疗是非常有效的治疗方法,不仅可避免开胸手术的风险,而且住院时间短、恢复快。

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