Academisch Medisch Centrum Amsterdam, The Netherlands.
Best Pract Res Clin Obstet Gynaecol. 2011 Aug;25(4):463-76. doi: 10.1016/j.bpobgyn.2011.01.004. Epub 2011 Mar 3.
Pre-eclampsia has a strong association with adverse outcomes: high incidences at term, and low incidences of morbidity; low incidences remote from term, high incidences of morbidity. The ultimate cure for pre-eclampsia is delivery of the placenta, but gestational age at delivery has an effect on perinatal outcome. We review aspects of two contrasting management approaches, and their indication areas are described (i.e. a more interventionist approach of stabilization (with antihypertensive drugs if needed and corticosteroids for acceleration of fetal lung maturation) and delivery, compared with a more temporizing approach, that treats the symptoms until delivery is necessary. In general, the temporizing approach has been shown to be safe, but beyond 37 weeks gestational age, there is evidence for better outcomes after early delivery. Below that gestational age, trials are awaited that help determine the balance in individual cases, depending on severity of maternal disease and fetal condition.
足月时发病率较高，而发病率较低；足月前发病率较低，发病率较高。子痫前期的最终治疗方法是分娩胎盘，但分娩时的胎龄会影响围产儿结局。我们回顾了两种对比管理方法的各个方面，并描述了它们的适应证（即更具干预性的稳定方法（如有需要使用降压药和皮质类固醇加速胎儿肺成熟）和分娩，与更姑息性的方法相比，该方法直到需要分娩才治疗症状。一般来说，已经证明姑息性方法是安全的，但在 37 周妊娠龄以上，早期分娩后有更好结局的证据。在该妊娠龄以下，正在等待试验来帮助确定个体病例的平衡，取决于母亲疾病和胎儿状况的严重程度。
