BC Women's Hospital and Health Centre and the Child and Family Research Institute, University of British Columbia, 4500 Oak Street, Room D213, Vancouver, BC V6H 3N1, Canada.
Curr Hypertens Rep. 2009 Dec;11(6):429-36. doi: 10.1007/s11906-009-0073-y.
The hypertensive disorders of pregnancy are a leading cause of maternal mortality and morbidity. Complications are not limited to preeclampsia but also complicate both preexisting hypertension and isolated gestational hypertension. Blood pressure (BP) management is important but is only one aspect of management of the hypertensive disorders of pregnancy, which may be caused or exacerbated by underlying uteroplacental mismatch between maternal supply and fetal demand. BP treatment thresholds and goals vary in international guidelines, largely reflecting differences in opinion rather than differences in published data. Because of short-term maternal risks, there is consensus that BP should be treated when sustained at greater than or equal to 160 to 170 mm Hg systolic and/or 110 mm Hg diastolic. There is no consensus regarding management of nonsevere hypertension, and randomized controlled trials involving just over 3000 women have not clarified the relative maternal and perinatal risks and benefits. Although antihypertensive therapy may decrease transient severe maternal hypertension, therapy may also impair fetal growth and perinatal health and outcomes. The CHIPS Trial (Control of Hypertension In Pregnancy Study) is recruiting to answer this question.
妊娠高血压疾病是孕产妇死亡和发病的主要原因。其并发症不仅包括子痫前期，还会使原有高血压和单纯妊娠期高血压复杂化。血压（BP）管理很重要，但只是妊娠高血压疾病管理的一个方面，其可能由母体供应与胎儿需求之间的胎盘-子宫不匹配引起或加重。国际指南中的 BP 治疗阈值和目标有所不同，主要反映了意见上的差异，而不是发表数据的差异。由于短期的母体风险，当收缩压大于或等于 160 至 170mmHg 和/或舒张压大于或等于 110mmHg 时，人们一致认为应该进行 BP 治疗。对于非重度高血压的管理尚无共识，涉及 3000 多名女性的随机对照试验并未阐明相对的母婴和围产儿风险和获益。虽然降压治疗可能会降低短暂的重度高血压，但治疗也可能会损害胎儿的生长和围产期健康及结局。CHIPS 试验（妊娠高血压控制研究）正在招募以回答这个问题。
