Medina Lomelí Juan Manuel, Medina Castro Néstor
Adscrito del servicio de ginecología y obstetricia del Hospital Español de México, Condesa.
Ginecol Obstet Mex. 2005 Jan;73(1):48-53.
Current criteria regarding hypertension in pregnancy consider two distinct types: gestational hypertension (pure type) and preeclampsia-eclampsia syndrome, the latter with albuminuria as a mandatory clinical fact. However, reports of lasts years show that a 15 to 46% of cases classified as pure type gestational hypertension evolve to a preeclamptic state, underlying the possibility that both clinical conditions represent diferent stages of the same disease. On the other hand, albuminuria may not be present in severe cases of pregnancy-related hypertensive disorders such as HELLP syndrome or eclampsia. It follows that if albuminuria is not necessary to establish the most severe forms of the disease, must the non-albuminuric hypertensive-type still be considered as a diferent diagnosis? This report reviews the medical literature on the subject, stressing similarities and diferences of both conditions in order to reflect about the need to change the classification concepts pregnancy-related hypertensive entities.
妊娠期高血压（单纯型）和子痫前期-子痫综合征，后者必有蛋白尿这一临床症状。然而，近年来的报告显示，15%至46%被归类为单纯型妊娠期高血压的病例会发展为子痫前期状态，这表明这两种临床情况可能是同一疾病的不同阶段。另一方面，在与妊娠相关的严重高血压疾病如HELLP综合征或子痫中，可能不存在蛋白尿。因此，如果蛋白尿并非诊断最严重形式疾病的必要条件，那么无蛋白尿的高血压类型是否仍应被视为不同的诊断？本报告回顾了关于该主题的医学文献，强调了这两种情况的异同，以思考是否有必要改变与妊娠相关的高血压疾病的分类概念。
