Chest pain during pregnancy: a clinical analysis of13 cases / 中华围产医学杂志

ABSTRACT

ObjectiveTo investigate the clinical feature, management, outcome and prognosis of chest pain during pregnancy.MethodsClinical data of 13 gravidas with chest pain admitted to the Fujian Medical University Union Hospital from January, 2013 to December, 2017 were analyzed retrospectively.Results Among the 13 cases, nine had acute chest pain (happen within 72 hours); two had chronic chest pain lasting over one month, and the other two had paroxysmal subacute chest pain (72 h to less than 30 d). Seven cases were complicated by cardiogenic disease/death including six with aortic dissection (patients No.1-6) and one with myocardial infarction (patient No.7). The remaining six cases were complicated by a variety of different non-cardiac conditions including transverse colon cancer (patient No.8), spontaneous pneumothorax (patient No.9), reflux esophagitis (patient No.11), intercostal neuralgia (patient No.12), acute leukemia (patient No.13) and idiopathic disease (patient No.10). Eight women underwent cesarean section, three delivered vaginally (patients No.8, No.10 and No.12), and two (patients No.7 and No.13) were aborted in the first trimester. Patient No.7 chose abortion in early pregnancy, 12 days after stent implantation, and was lost to follow up after discharge. Patient No.13 underwent induced abortion following two courses of chemotherapy against acute leukemia and was also lost to follow up. Patient No.2 died due to the septic shock and subsequent multi-organ dysfunction syndrome after cesarean section and aortic surgery. The remaining ten cases did not report any abnormalities during follow-up. Among the 11 neonates, seven were preterm infants. All of the 11 babies were normal in follow-ups except one preterm infant (case 8) showed growth retardation at 11 months old.ConclusionsChest pain during pregnancy may be caused by various reasons, and the severity varies greatly, and may even result in maternal and infant deaths in some circumstances. Early identification diagnosis and timely intervention are required to improve maternal and fetal outcomes.