Beaufils Michel
Service de médecine interne, Hôpital Tenon, 75970 Paris.
Rev Prat. 2003 Nov 15;53(17):1878-88.
Hypertension is the most common medical complication of pregnancy. Isolated and moderate hypertensions most often have an uneventful course. On the contrary, preeclampsia is a severe condition, that threatens the fetal survival, and even maternal prognosis. Recent knowledge demonstrates that preeclampsia is related to a very early defect in placentation, with late maternal systemic effects. This has important practical counterparts. Any manifestation of placental dysfunction should be detected as early as possible. Antihypertensive treatment should be used with great caution, to preserve an appropriate blood flow through a placenta whose hemodynamic resistance is high. Finally, the most appropriate therapeutic way is a preventive one. Cardiovascular risk of those young women should be later monitored.
高血压是妊娠最常见的医学并发症。单纯性和中度高血压通常病程平稳。相反,子痫前期是一种严重疾病,会威胁胎儿存活,甚至影响母亲预后。最新研究表明,子痫前期与胎盘形成的早期缺陷有关,并伴有后期母体全身影响。这具有重要的实际意义。应尽早检测出胎盘功能障碍的任何表现。使用抗高血压治疗时应格外谨慎,以维持通过血流动力学阻力较高的胎盘的适当血流量。最后,最合适的治疗方法是预防性治疗。这些年轻女性的心血管风险日后应予以监测。