Plouin P F, Breart G, Llado J, Dalle M, Keller M E, Goujon H, Berchel C
Institut National de la Santé et de la Recherche Médicale, Units 36 and 149, Paris.
Br J Obstet Gynaecol. 1990 Feb;97(2):134-41. doi: 10.1111/j.1471-0528.1990.tb01738.x.
Two treatment strategies were compared in 155 women with pregnancy-induced hypertension who were also given comprehensive non-pharmacological care. The mean gestation at entry was 28 weeks. As long as the diastolic blood pressure (DBP) remained below 106 mmHg, oxprenolol, or oxprenolol plus dihydralazine, were given to the early treatment group, and matching placebos to the control group. Open antihypertensive treatment was provided for patients whose DBP rose above 105 mmHg. Proteinuria occurred in seven women in each group. In the early treatment group, 13 of the 78 women were delivered by caesarean section; the corresponding numbers in the control group were 27 of 76 (17 vs 36%, 95% confidence interval (CI) of difference: 5-33%); the sections included seven and 16 in the early treatment and control groups, respectively, for severe hypertension and/or fetal distress. There were five perinatal deaths, two in the early treatment group and three in the control group. Early treatment did not influence gestational age at birth or birthweight. Respiratory distress syndrome occurred in four infants in the early treated group and in 10 in the control group; 14 infants in the former group and 26 in the latter were in hospital for more than 10 days (18 vs 35%; 95% CI of difference 4-32%). These results indicate that early antihypertensive treatment with oxprenolol is safe for the fetus and newborn in pregnancy-induced hypertension, but has no advantage over non-pharmacological care in terms of fetal growth. However, it may prevent acute hypertension in late pregnancy and associated fetal distress, and thus reduce the number of caesarean sections.
在155名妊娠高血压妇女中比较了两种治疗策略，这些妇女同时接受了全面的非药物治疗。入组时的平均孕周为28周。只要舒张压（DBP）保持在106 mmHg以下，早期治疗组给予氧烯洛尔或氧烯洛尔加双肼屈嗪，对照组给予匹配的安慰剂。DBP升至105 mmHg以上的患者接受开放的抗高血压治疗。每组有7名妇女出现蛋白尿。早期治疗组的78名妇女中有13名通过剖宫产分娩；对照组的76名妇女中有27名（17%对36%，差异的95%置信区间（CI）：5%-33%）；早期治疗组和对照组分别有7例和16例剖宫产是因为重度高血压和/或胎儿窘迫。围产期死亡5例，早期治疗组2例，对照组3例。早期治疗不影响出生时的孕周或出生体重。早期治疗组有4名婴儿发生呼吸窘迫综合征，对照组有10名；前一组有14名婴儿、后一组有26名婴儿住院超过10天（18%对35%；差异的95%CI为4%-32%）。这些结果表明，在妊娠高血压中，用氧烯洛尔进行早期抗高血压治疗对胎儿和新生儿是安全的，但在胎儿生长方面并不优于非药物治疗。然而，它可能预防妊娠晚期的急性高血压及相关的胎儿窘迫，从而减少剖宫产的数量。
