Objective: To investigate the characteristics of pregnancy with pre-excitation syndrome and its influence on pregnancy outcomes. Methods: A retrospective analysis was made on the clinical data of 62 cases of pregnancy complicated with pre-excitation syndrome in Beijing Anzhen Hospital from Jan. 2008 to Dec. 2008. According to whether there was a supraventricular tachycardia (SVT) in pregnancy, they were divided into two groups. There were 16 pregnant women in the SVT seizure group during pregnancy, and 46 pregnant women in no SVT seizure group, with a multi-disciplinary comprehensive diagnosis and treatment model. SPSS software was used to analyze the data and compare the gestational age, age and weight of the newborn, and then compare the pregnancy outcomes. Results: (1) The total number of deliveries in Beijing Anzhen Hospital during the study period was 21 786, and the patients with pregnancy combined with pre-excitation syndrome account for 0.28% (62/21 786). (2) Totally 44 patients (71%, 44/62) were diagnosed with pre-excitation syndrome before pregnancy, and 18 patients (29%, 18/62) were diagnosed for the first-time during pregnancy. Among patients diagnosed with pre-excitation syndrome before pregnancy, 16 patients (36%, 16/44) had seizures before pregnancy, 28 patients (64%, 28/44) had asymptomatic before pregnancy, and 4 of asymptomatic patients had SVT during pregnancy. (3) Of the 16 pregnant women in the SVT seizure group during pregnancy, 2 patients (2/16) had SVT episodes in the first trimester, 5 patients (5/16) had SVT episodes in the second trimester, 9 patients (9/16) had SVT episodes in the third trimester. In the SVT seizure group, 8 patients (8/16) had SVT episodes before pregnancy, and 8 patients (8/16) had no SVT episodes before pregnancy. There were 46 patients in the SVT seizure-free group during pregnancy, including 9 patients with SVT attacks before pregnancy and 37 patients without SVT before pregnancy. (4) Compared with the pregnant women in the SVT seizure group, the age, weight gained during pregnancy, delivery gestation week, newborn weight, and the time of the first and second labors were not statistically different between the two groups of pregnant women (all P>0.05). However, the total duration of labor in the SVT seizure group during pregnancy was shorter and pre-pregnancy weight was lower (all P<0.05). The rate of cesarean section in pregnant women with SVT attack was 12/16, and the rate of cesarean section in pregnant women without SVT was 50% (23/46; P=0.051). No pregnant woman had an arrhythmia during delivery. Conclusions: SVT episode in patients during pregnancy most occurs in the third trimester. Patients who are asymptomatic before pregnancy may also have SVT during pregnancy. Pre-excitation syndrome patients with SVT attacks during pregnancy increase adverse pregnancy outcomes. Multidisciplinary comprehensive management could effectively control pregnant women with pre-excitation syndrome, effectively reduce the occurrence of serious arrhythmia risk events during pregnancy, so that most patients could get good pregnancy outcomes.
目的： 探讨妊娠合并预激综合征的临床特点及对妊娠结局的影响。 方法： 对首都医科大学附属北京安贞医院2008年1月至2018年12月妊娠合并预激综合征住院分娩孕妇62例的临床资料进行回顾性分析。根据是否有妊娠期室上性心动过速（SVT）发作分为：SVT发作组（妊娠期有SVT发作），16例；未发作组（妊娠期无SVT发作），46例，予多学科综合诊疗管理。通过SPSS 22软件进行数据的统计学分析，比较孕妇年龄、分娩孕周、产程时间、新生儿出生体重等，进而分析妊娠结局。 结果： （1）研究期间本院分娩总量为21 786例，妊娠合并预激综合征62例，占0.28%（62/21 786）。（2）本组62例中，有44例（71%，44/62）妊娠前诊断预激综合征，18例（29%，18/62）为妊娠期首次诊断。44例妊娠前诊断预激综合征的孕妇中，有16例（36%，16/44）妊娠前有发作，28例（64%，28/44）妊娠前无症状，妊娠前无症状者中有4例在妊娠期发作SVT。（3）SVT发作组的16例孕妇中，孕早期有SVT发作者有2例（2/16），孕中期有SVT发作者有5例（5/16），孕晚期有SVT发作者有9例（9/16）。SVT发作组有8例（8/16）妊娠前有SVT发作，8例（8/16）妊娠前无SVT发作。未发作组的46例孕妇中，妊娠前有SVT发作者9例，妊娠前无SVT发作者37例。（4）SVT发作组与未发作组孕妇相比，年龄、孕期体重增加、分娩孕周、新生儿出生体重、第一产程时间、第二产程时间均无差异（P均>0.05），但SVT发作组孕妇的孕前体重较轻、总产程时间较短，两组分别比较，差异有统计学意义（P均<0.05）。SVT发作组孕妇的剖宫产率为12/16，未发作组的剖宫产率为50%（23/46），两组比较，差异无统计学意义（P=0.051）。无孕妇于分娩过程中发作心律失常。 结论： 妊娠合并预激综合征孕妇妊娠期SVT发作多发生在孕晚期，妊娠前无症状者妊娠期也有发生SVT的可能性。妊娠合并预激综合征孕妇的妊娠期SVT发作可增加不良妊娠结局。多学科综合诊疗管理可有效对妊娠合并预激综合征孕妇进行管理，有效减少孕期严重心律失常风险事件的发生，大多数可获得良好的妊娠结局。.
Keywords: Pre-excitation syndromes; Pregnancy complication; Pregnancy outcome; Tachycardia, supraventricular.