Duley Lelia
University of Leeds, Academic Unit, Leeds, UK.
BMJ Clin Evid. 2011 Feb 14;2011:1402.
Pre-eclampsia (raised blood pressure and proteinuria) complicates 2% to 8% of pregnancies, and raises morbidity and mortality in the mother and child. Pre-eclampsia is more common in women with multiple pregnancy and in those who have conditions associated with microvascular disease.
We conducted a systematic review and aimed to answer the following clinical questions: what are the effects of preventive interventions in women at risk of pre-eclampsia? What are the effects of interventions in women who develop mild to moderate hypertension during pregnancy? What are the effects of interventions in women who develop severe pre-eclampsia or very high blood pressure during pregnancy? What is the best choice of anticonvulsant for women with eclampsia? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 69 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: anticonvulsants, antihypertensive drugs, antioxidants, antiplatelet drugs, atenolol, bed rest, hospital admission, or day care, calcium supplementation, choice of analgesia during labour, early delivery (interventionist care), evening primrose oil, fish oil, glyceryl trinitrate, magnesium supplementation, plasma volume expansion, and salt restriction.
子痫前期（血压升高和蛋白尿）使2%至8%的妊娠复杂化，并增加母婴的发病率和死亡率。子痫前期在多胎妊娠妇女以及患有与微血管疾病相关病症的妇女中更为常见。
我们进行了一项系统评价，旨在回答以下临床问题：子痫前期风险女性预防性干预措施的效果如何？孕期发生轻度至中度高血压的女性干预措施的效果如何？孕期发生重度子痫前期或血压极高的女性干预措施的效果如何？子痫患者抗惊厥药物的最佳选择是什么？我们检索了：截至2010年2月的医学期刊数据库（Medline）、荷兰医学文摘数据库（Embase）、考克兰图书馆以及其他重要数据库（临床证据综述会定期更新，请查看我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品及保健品监管局（MHRA）等相关组织的危害警示。
我们发现69项系统评价、随机对照试验或观察性研究符合我们的纳入标准。我们对干预措施证据的质量进行了GRADE评估。
在本系统评价中，我们呈现了以下干预措施有效性和安全性的相关信息：抗惊厥药物、抗高血压药物、抗氧化剂、抗血小板药物、阿替洛尔、卧床休息、住院或日间护理、补钙、分娩时镇痛的选择、早期分娩（干预性护理）、月见草油、鱼油、硝酸甘油、补镁、血浆扩容和限盐。
