Objective: To investigate the clinical characteristics and pregnancy outcomes in pregnant women with left ventricular non-compaction (LVNC). Methods: The clinical data of seven pregnant women with LVNC from January 2011 to December 2021 in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed, including age, gestational age of symptom first occured, LVNC history, clinical symptoms, New York Heart Association (NYHA) cardiac function class, echocardiography, blood brain natriuretic peptide (BNP), treatment and the maternal and fetal outcomes. Results: Five cases were diagnosed before pregnancy, of which there were three women with medication; one case diagnosed in the month of pregnancy; one case diagnosed at 36 weeks of gestation. NYHA cardiac function was grade Ⅰ in four cases and grade Ⅱ in three cases before or during the first trimester of pregnancy. Of the five pregnant women who underwent echocardiography, there were one case of left ventricular insufficiency, three cases of mild left ventricular dysfunction and one case of normal left ventricular function before or during the first trimester of pregnancy. Of the five pregnant women to the second and third trimester of pregnancy, there were one case of grade Ⅳ, one case of grade Ⅲ, two cases of grade Ⅱ-Ⅲ and one case of grade Ⅱ in NYHA class ; three cases of left ventricular insufficiency, two cases of normal left ventricular function by echocardiography four cases had cardiac symptoms at 15-24 weeks of gestation and were treated with medication. In four cases, blood BNP increased to 214-1 197 ng/L during pregnancy, and were 89-106 ng/L after termination of pregnancy. There were 4 cases with arrhythmia. Indications for termination of pregnancy: LVNC complicated with heart failure in two cases, LVNC complicated with decreased cardiac function and threatened preterm birth in one case, complicated with pregnancy at full term in two cases, LVNC complicated with severe pulmonary hypertension in one case, and left ventricular dysfunction in one case. Cesarean section in four cases in the third-trimester, in one case in the second-trimester, and forceps curettage in two cases were taken. Two full-term infants,two preterm infants were born without LVNC. Conclusions: Women diagnosed with LVNC and low left ventricular ejection fraction before pregnancy are more prone to decreased cardiac function during pregnancy. Carrying out pregnancy risk assessment and strengthening the multi-disciplinary team management of high risk factors in pregnancy are conducive to achieve good pregnancy outcomes.
目的： 探讨妊娠合并左心室心肌致密化不全（LVNC）孕妇的临床特征和妊娠结局。 方法： 回顾性分析首都医科大学附属北京安贞医院2011年1月至2021年12月收治的7例妊娠合并LVNC孕妇的临床资料，包括年龄、症状首发孕周、LVNC病史、症状、心功能分级、超声心动图检查、血脑钠肽（BNP）、治疗及母儿结局。 结果： 7例妊娠合并LVNC孕妇中，妊娠前诊断LVNC 5例，其中药物治疗3例；妊娠当月诊断1例；妊娠36周诊断1例。妊娠前或妊娠早期心功能Ⅰ级4例，Ⅱ级3例；超声心动图检查5例，其中左心功能不全1例，轻度左心功能障碍3例，左心功能正常1例。妊娠至中晚期者5例，其中心功能Ⅳ级1例，Ⅲ级1例，Ⅱ~Ⅲ级2例，Ⅱ级1例；超声心动图检查左心功能不全3例，左心功能正常2例；4例妊娠15~24周出现心脏症状，予药物治疗；血BNP水平升高3例，妊娠期最高水平为214~1 197 ng/L，终止妊娠后89.0~106.0 ng/L；终止妊娠前伴心律失常4例。7例LVNC孕妇中，终止妊娠指征为LVNC并发心力衰竭2例，LVNC并心功能减低、早产临产1例，妊娠合并LVNC足月2例，妊娠早期LVNC合并重度肺动脉高压1例，合并左心功能不全1例；妊娠晚期剖宫产术4例，妊娠中期剖宫取胎术1例，妊娠早期钳刮术2例；获新生儿4例，其中足月儿2例，早产儿2例，均未发现LVNC改变。 结论： 妊娠前诊断LVNC且左心室射血分数低的妇女，更易早期出现心功能减低。妊娠风险评估与分层、多学科协作诊治管理，有利于获得更好的妊娠结局。.