Tomoda S, Kitanaka T, Nakamoto O, Hidaka A, Sugawa T
Department of Obstetrics and Gynecology, Osaka City University Medical School.
Nihon Sanka Fujinka Gakkai Zasshi. 1992 Mar;44(3):297-302.
The criteria for pregnancy induced hypertension ("PIH" which is a hypertensive type of toxemia) have been determined by the Japanese Obstetrics and Gynecology Society. Mild PIH is classified into two types. One is "Absolute PIH (A-PIH)" diagnosed by (1) systolic blood pressure (SBP) greater than or equal to 140 mmHg and less than 160 mmHg or (2) diastolic blood pressure (DBP) greater than or equal to 90 mmHg and less than 110 mmHg. The other one is "relative-PIH (R-PIH)" diagnosed by (3) an increase in SBP greater than or equal to 30 mmHg compared to usual SBP or (4) an increase in DBP greater than or equal to 15 mmHg compared to usual DBP (In this paper, blood pressure prior to the 12th gestational week is considered as "usual" blood pressure). We have already investigated the pathophysiological difference through the background and the change in blood pressure throughout pregnancy and puerperium in these two types of PIH. The purpose of this study is to clarify the pathophysiological difference by evaluating the influence of hypertension on fetal growth. We evaluated 963 nullipara and 747 multipara whose pregnancies were recorded from the 1st trimester (multiple pregnancy and pre-term delivery before the 32nd gestational week were excluded). Among nullipara, 765 women (79.4%) were diagnosed as having normal blood pressure (N-group), 7.1% as A-PIH, and 13.0% as R-PIH. Among multipara, the N-group consisted of 632 women (84.6%), A-PIH: 4.6% and R-PIH: 10.3%. There is no difference among the three groups in gestational days but the body weight, the chest circumference, and the abdominal girth at birth of A-PIH show a significant difference from those of the R-PIH and N-groups in both nullipara and multipara.(ABSTRACT TRUNCATED AT 250 WORDS)
日本妇产科学会已确定了妊娠高血压(“PIH”,一种高血压型毒血症)的诊断标准。轻度PIH分为两种类型。一种是“绝对PIH(A-PIH)”,诊断标准为:(1)收缩压(SBP)大于或等于140 mmHg且小于160 mmHg,或(2)舒张压(DBP)大于或等于90 mmHg且小于110 mmHg。另一种是“相对PIH(R-PIH)”,诊断标准为:(3)SBP较平时升高大于或等于30 mmHg,或(4)DBP较平时升高大于或等于15 mmHg(本文中,妊娠第12周前的血压被视为“平时”血压)。我们已经通过这两种类型PIH的背景以及整个孕期和产褥期血压变化研究了其病理生理差异。本研究的目的是通过评估高血压对胎儿生长的影响来阐明病理生理差异。我们评估了963例初产妇和747例经产妇,这些孕妇的妊娠记录始于孕早期(排除多胎妊娠和妊娠32周前的早产)。在初产妇中,765名女性(79.4%)被诊断为血压正常(N组),7.1%为A-PIH,13.0%为R-PIH。在经产妇中,N组有632名女性(84.6%),A-PIH为4.6%,R-PIH为10.3%。三组的孕周无差异,但初产妇和经产妇中A-PIH组出生时的体重、胸围和腹围与R-PIH组和N组相比均有显著差异。(摘要截断于250字)