1例主动脉瓣狭窄合并宫内生长受限孕妇的护理

Oliwia Stępień, A. Leja-Szpak
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摘要

主动脉瓣狭窄是最常见的获得性心脏缺陷,它涉及到主动脉瓣面积的缩小。在孕妇的情况下,这种缺陷,由于心血管系统的变化,导致流产,早产,或宫内生长受限(IUGR)。IUGR是一种胎儿相对于胎龄太小的情况,其后果可能包括围产期缺氧、胎粪吸入综合征或呼吸窘迫综合征。本研究目的:分析1例30岁女性妊娠期诊断为主动脉瓣狭窄合并宫内生长受限的病例,为该孕妇制定诊断和护理及产科护理方案。讨论:本论文包括一个在怀孕期间发现主动脉狭窄并宫内生长受限的孕妇的病例研究。分析涉及病人计划的住院治疗。住院治疗的基本内容包括控制一般情况和产科情况,监测胎儿状况,以及旨在改善孕妇血流动力学状况的药物治疗。结论:孕妇主动脉瓣狭窄并发IUGR是一种罕见的临床情况。为这类孕妇提供医疗保健的重点是控制一般和产科参数。助产士参与药物治疗和协助医生检查也是获取有关这种疾病的信息以及规划护理和产科护理的重要因素。
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Care of a pregnant woman with aortic stenosis and intrauterine growth restriction – case study
Introduction: Stenosis of the aortic valve is the most common acquired heart defect, which involves reducing the area of this valve. In the case of pregnant women, this defect, due to changes in the cardiovascular system, results in miscarriages, pre-term delivery, or intrauterine growth restriction (IUGR). IUGR is a condition in which the foetus is too small in relation to gestational age, and its consequences may include perinatal hypoxia, meconium aspiration syndrome, or respiratory distress syndrome. Aim of the study: To analyse the case of a 30-year-old female patient with aortic stenosis and intrauterine growth restriction, diagnosed during pregnancy, as well as to formulate diagnoses and plan nursing and obstetric care for this pregnant woman. Discussion: The present thesis includes a case study of a pregnant woman with aortic stenosis detected during pregnancy and intrauterine growth restriction. The analysis concerned the patient’s planned hospitalisation. The essential elements of hospitalisation included the control of general and obstetric conditions, monitoring of the foetus’ condition, as well as pharmacotherapy that aimed at improving the haemodynamic conditions of the pregnant woman. Conclusions: Narrowing of the aortic valve in pregnant women complicated by the occurrence of IUGR is a rare clinical condition. Providing medical care of such a pregnant woman focuses on the control of general and obstetrical parameters. The participation of a midwife in pharmacotherapy and assisting in the doctor’s examinations also constitutes an important element in obtaining information about this medical condition, as well as planning nursing and obstetric care.
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