Abstract: Background　 Infective endocarditis in pregnancy is quite rare.At present，there are several reported cases，while the characteristics，risk factors，pathogens，treatment，prognosis of mothers and infants are still unclear.Moreover，it is also difficulty for medicines in antibiotics，anesthetics and timing of surgery.Objective　To explore the risk factors，clinical features，and maternal and infant outcomes of infective endocarditis（IE） in pregnancy based on the reviewing of articles about IE in pregnancy published in recent 10 years.It may provide a scientific basis for the treatment of this disease.Methods　Articles about IE in pregnancy published during January 2008 to January 2018 were searched from September 2017 to July 2018，from the electronic databases of PubMed，EMbase，Ovid，Cochrane Library，ENTRAL，CBM，VIP，CNKI and Wanfang Data Knowledge Service Platform.Data extraction was conducted.The clinical characteristics，risk factors and pathogens of IE in pregnancy，maternal and infant mortality from IE in pregnancy were analyzed.Results　A total of 34 articles were included，involving 42 cases of IE in pregnancy.The average onset age was（27.9±5.3） years.The common clinical symptoms were fever（31 cases），cough（13 cases），dyspnea（11 cases），accounting for 73.8%，31.0%，and 26.2% of the total，respectively.The major risk factors for IE in pregnancy were congenital heart disease（13 cases） and intravenous drug abuse（6 cases），accounting for 31.0% and 14.3% of the total，respectively.Left atrioventricular valve was the site mainly involved，often with valve excrescences and abnormal heart murmurs.The rate of positive blood culture results was 84.2%（32 cases），and the detected major pathogenic bacteria were Staphylococcus and Streptococcus.The maternal mortality was 9.5%.Of the 42 fetuses，31（73.8%） healthy ones were delivered and discharged from hospital，3 （7.1%） were dead fetuses，1（2.4%） was aborted medically，and other 7 （16.7%） had unknown outcomes.Conclusion　 IE in pregnancy is quite rare and it has no typical clinical presentations.Moreover，it may easily cause maternal and infant deaths.Therefore，for pregnant women with recurrent fever and abnormal heart murmurs detected during auscultation，echocardiography and blood culture test should be underwent timely，in order to determine whether they have IEF，and for those with a definite diagnosis of IE，multidisciplinary treatment should be performed as soon as possible if necessary.

Key words: Endocarditis, bacterial；Pregnancy complications；Ecocardiography；Infant mortality

摘要： 背景　妊娠合并感染性心内膜炎临床罕见，目前虽然已有个案报道，但是其发病特征、危险因素、病原微生物分布、治疗方式和母婴预后均不明确。临床医生在抗生素、麻醉药物和手术时机选择等方面面临许多困扰。 目的　检索近10年国内外妊娠合并感染性心内膜炎的文献报道，分析其危险因素、临床特征和母婴结局，为妊娠合并感染性心内膜炎患者的治疗提供科学依据。方法　2017年9月—2018年7月，计算机检索PubMed、EMbase、Ovid、Cochrane Library、ENTRAL、中国生物医学文献服务系统、维普网、中国知网、万方数据知识服务平台2008年1月—2018年1月的相关文献，提取文献相关数据，分析妊娠合并感染性心内膜炎的临床特征、危险因素、病原微生物、孕妇病死率、婴儿病死率。结果　共纳入34篇参考文献，包含42例妊娠合并感染性心内膜炎患者，患者平均发病年龄为（27.9±5.3）岁。发热、咳嗽、呼吸困难是较常见的症状，分别为31例（73.8%）、13例（31.0%）、11例（26.2%）。危险因素主要为先天性心脏病和静脉滥用药，分别为13例（31.0%）和6例（14.3%）。病灶主要累及左房室瓣，常出现瓣膜赘生物和心脏杂音。血培养阳性率为84.2%（32例），病原菌主要是葡萄球菌和链球菌。孕妇病死率为9.5%。42例婴儿中，31例（73.8%）健康出院，3例死亡（7.1%），1例医学终止妊娠（2.4%），7例结局不明（16.7%）。结论　妊娠合并感染心内膜炎临床罕见，缺乏典型的临床表现，极易导致孕妇及婴儿死亡。因此，对于反复发热且心脏听诊有杂音的孕妇，应高度警惕此病，尽早完成心脏彩超、血培养检查并实施多学科协作。

关键词: 心内膜炎, 细菌性, 妊娠并发症, 超声检查, 婴儿病死率